Abstract

Studies using univariate analysis from China, Italy and the USA, as well as multivariate analysis from USA and UK have shown that people with diabetes have a higher risk of more adverse outcomes from COVID-19 compared with people without diabetes. However, the differential risks between type 1 versus type 2 diabetes remains unreported. Using data from the COVID patient notification system, UK investigators have studied the relative and absolute risk of in-hospital related death with COVID-19 in people with type 1 and type 2 diabetes. There were 23,804 hospital deaths with COVID-19 in England reported to 11th May 2020. Overall, one third of these deaths occurred in people with diabetes. Adjusted for age, sex, deprivation, ethnicity and geographical regions, people with type 1 and type 2 diabetes had 3.5 and 2.03 times the relative risk of dying in hospital from COVID-19 compared to those without diabetes. To put this into context however, age appears to be a major factor for people with diabetes at risk of death with COVID-19. Mean age of death in type 1 diabetes was 72 years and type 2 diabetes was 77.9 years. Moreover, the odd ratio for death in people <40 years was 0.01, whereas for people >80 years was 9.14 (both relative to reference age group of 60-69 years. Additional important risk factors which adjusted and increases the risk of in-patient death with COVID-19 in people with type 1 and type 2 diabetes are social deprivation, British Asian Minority ethnic (BAME) group and presence of comorbidities such as coronary heart disease, cerebrovascular disease and heart failure.

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