TY - JOUR

T1 - Association Between Diabetes and Mortality Among Adult Patients Hospitalized With COVID-19

T2 - A Cohort Study of Hospitalized Adults in Ontario, Canada, and Copenhagen, Denmark

AU - Bogler, Orly

AU - Raissi, Afsaneh

AU - Colacci, Michael

AU - Beaman, Andrea

AU - Biering-Sørensen, Tor

AU - Cressman, Alex

AU - Detsky, Allan

AU - Gosset, Alexi

AU - Lassen, Mats Højbjerg

AU - Kandel, Chris

AU - Khaykin, Yaariv

AU - Barbosa, David

AU - Lapointe-Shaw, Lauren

AU - MacFadden, Derek R.

AU - Pearson, Alexander

AU - Perkins, Bruce A.

AU - Rothman, Kenneth J.

AU - Skaarup, Kristoffer Grundtvig

AU - Weagle, Rachael

AU - Yarnell, Chris

AU - Sholzberg, Michelle

AU - Hodzic-Santor, Benazir

AU - Lovblom, Erik

AU - Zipursky, Jonathan

AU - Quinn, Kieran L.

AU - Fralick, Mike

N1 - Publisher Copyright: © 2023 Canadian Diabetes Association

PY - 2023

Y1 - 2023

N2 - Objectives: Diabetes has been reported to be associated with an increased risk of death among patients with COVID-19. However, the available studies lack detail on COVID-19 illness severity and measurement of relevant comorbidities. Methods: We conducted a multicentre, retrospective cohort study of patients 18 years of age and older who were hospitalized with COVID-19 between January 1, 2020, and November 30, 2020, in Ontario, Canada, and Copenhagen, Denmark. Chart abstraction emphasizing comorbidities and disease severity was performed by trained research personnel. The association between diabetes and death was measured using Poisson regression. The main outcome measure was in-hospital 30-day risk of death. Results: Our study included 1,133 hospitalized patients with COVID-19 in Ontario and 305 in Denmark, of whom 405 and 75 patients, respectively, had pre-existing diabetes. In both Ontario and Denmark, patients with diabetes were more likely to be older; have chronic kidney disease, cardiovascular disease, and higher troponin levels; and be receiving antibiotics, when compared with adults without diabetes. In Ontario, 24% (n=96) of adults with diabetes died compared with 15% (n=109) of adults without diabetes. In Denmark, 16% (n=12) of adults with diabetes died in hospital compared with 13% (n=29) of those without diabetes. In Ontario, the crude mortality ratio among patients with diabetes was 1.60 (95% confidence interval [CI], 1.24 to 2.07) and in the adjusted regression model it was 1.19 (95% CI, 0.86 to 1.66). In Denmark, the crude mortality ratio among patients with diabetes was 1.27 (95% CI, 0.68 to 2.36) and in the adjusted model it was 0.87 (95% CI, 0.49 to 1.54). Meta-analysis of the 2 rate ratios from each region resulted in a crude mortality ratio of 1.55 (95% CI, 1.22 to 1.96) and an adjusted mortality ratio of 1.11 (95% CI, 0.84 to 1.47). Conclusion: The presence of diabetes was not strongly associated with in-hospital COVID-19 mortality independent of illness severity and other comorbidities.

AB - Objectives: Diabetes has been reported to be associated with an increased risk of death among patients with COVID-19. However, the available studies lack detail on COVID-19 illness severity and measurement of relevant comorbidities. Methods: We conducted a multicentre, retrospective cohort study of patients 18 years of age and older who were hospitalized with COVID-19 between January 1, 2020, and November 30, 2020, in Ontario, Canada, and Copenhagen, Denmark. Chart abstraction emphasizing comorbidities and disease severity was performed by trained research personnel. The association between diabetes and death was measured using Poisson regression. The main outcome measure was in-hospital 30-day risk of death. Results: Our study included 1,133 hospitalized patients with COVID-19 in Ontario and 305 in Denmark, of whom 405 and 75 patients, respectively, had pre-existing diabetes. In both Ontario and Denmark, patients with diabetes were more likely to be older; have chronic kidney disease, cardiovascular disease, and higher troponin levels; and be receiving antibiotics, when compared with adults without diabetes. In Ontario, 24% (n=96) of adults with diabetes died compared with 15% (n=109) of adults without diabetes. In Denmark, 16% (n=12) of adults with diabetes died in hospital compared with 13% (n=29) of those without diabetes. In Ontario, the crude mortality ratio among patients with diabetes was 1.60 (95% confidence interval [CI], 1.24 to 2.07) and in the adjusted regression model it was 1.19 (95% CI, 0.86 to 1.66). In Denmark, the crude mortality ratio among patients with diabetes was 1.27 (95% CI, 0.68 to 2.36) and in the adjusted model it was 0.87 (95% CI, 0.49 to 1.54). Meta-analysis of the 2 rate ratios from each region resulted in a crude mortality ratio of 1.55 (95% CI, 1.22 to 1.96) and an adjusted mortality ratio of 1.11 (95% CI, 0.84 to 1.47). Conclusion: The presence of diabetes was not strongly associated with in-hospital COVID-19 mortality independent of illness severity and other comorbidities.

KW - care processes

KW - comorbidities

KW - COVID-19

KW - COVID-19 mortality

KW - COVID-19 severity

KW - diabetes

U2 - 10.1016/j.jcjd.2023.02.005

DO - 10.1016/j.jcjd.2023.02.005

M3 - Journal article

C2 - 37074240

AN - SCOPUS:85152969837

VL - 47

SP - 352

EP - 358

JO - Canadian Journal of Diabetes

JF - Canadian Journal of Diabetes

SN - 1499-2671

IS - 4

ER -