A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection
Aims/hypothesis The aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK. Methods A retrospective cohort study was performed using data collected thr...
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| Veröffentlicht in: | Diabetologia 2021-08, Vol.64 (8), p.1717-1724 |
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| creator | Ruan, Yue Ryder, Robert E. J. De, Parijat Field, Benjamin C. T. Narendran, Parth Iqbal, Ahmed Gandhi, Rajiv Harris, Sophie Nagi, Dinesh Aziz, Umaira Karra, Efthimia Ghosh, Sandip Hanif, Wasim Edwards, Amy E. Zafar, Mansoor Dashora, Umesh Várnai, Kinga A. Davies, Jim Wild, Sarah H. Wilmot, Emma G. Webb, David Khunti, Kamlesh Rea, Rustam |
| description | Aims/hypothesis
The aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK.
Methods
A retrospective cohort study was performed using data collected through a nationwide audit of people admitted to hospital with diabetes and COVID-19, conducted by the Association of British Clinical Diabetologists from March to October 2020. Prespecified demographic, clinical, medication and laboratory data were collected from the electronic and paper medical record systems of the participating hospitals by local clinicians. The primary outcome of the study, severe COVID-19, was defined as death in hospital and/or admission to the adult intensive care unit (AICU). Logistic regression models were used to generate age-adjusted ORs.
Results
Forty UK centres submitted data. The final dataset included 196 adults who were admitted to hospital and had both type 1 diabetes and COVID-19 on admission (male sex 55%, white 70%, with mean [SD] age 62 [19] years, BMI 28.3 [7.3] kg/m
2
and last recorded HbA
1c
76 [31] mmol/mol [9.1 (5.0)%]). The prevalence of pre-existing microvascular disease and macrovascular disease was 56% and 39%, respectively. The prevalence of diabetic ketoacidosis on admission was 29%. A total of 68 patients (35%) died or were admitted to AICU. The proportions of people that died were 7%, 38% and 38% of those aged |
| doi_str_mv | 10.1007/s00125-021-05463-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8106514</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2546782991</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-7f5c0b4d9b008309cf1350be34f46f1362cceaa4f11107ad7656e8c62435bca13</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EotuFP8ABWeLCxTD-iJNckKqFQkWlXijiZjnOpOsqG4fYabv_Hi8p5ePAySO9z7yemZeQFxzecIDybQTgomAgOINCacnuHpEVV1IwUKJ6TFYHnfFKfzsixzFeA4DM3FNyJGWtNdSwIvaEXn6mg00-DLe-RRrT3O5p6OiIYeyR3vq0pWk_IuW09bbBhJHadudTwpamQLchjj7ZfiE3F1_P3jNeUz906A6uz8iTzvYRn9-_a3J5-uHL5hM7v_h4tjk5Z06VKrGyKxw0qq0bgEpC7TouC2hQqk7pXGvhHFqrOs45lLYtdaGxclooWTTOcrkm7xbfcW522Doc0mR7M05-Z6e9Cdabv5XBb81VuDEVB13ks63J63uDKXyfMSaz89Fh39sBwxyNKISqKqlUmdFX_6DXYZ6GvF6mlC4rUdeHicRCuSnEOGH3MAwHc0jQLAmanKD5maC5y00v_1zjoeVXZBmQCxCzNFzh9Pvv_9j-ANC7ps8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2546782991</pqid></control><display><type>article</type><title>A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection</title><source>Springer Nature - Complete Springer Journals</source><creator>Ruan, Yue ; Ryder, Robert E. J. ; De, Parijat ; Field, Benjamin C. T. ; Narendran, Parth ; Iqbal, Ahmed ; Gandhi, Rajiv ; Harris, Sophie ; Nagi, Dinesh ; Aziz, Umaira ; Karra, Efthimia ; Ghosh, Sandip ; Hanif, Wasim ; Edwards, Amy E. ; Zafar, Mansoor ; Dashora, Umesh ; Várnai, Kinga A. ; Davies, Jim ; Wild, Sarah H. ; Wilmot, Emma G. ; Webb, David ; Khunti, Kamlesh ; Rea, Rustam</creator><creatorcontrib>Ruan, Yue ; Ryder, Robert E. J. ; De, Parijat ; Field, Benjamin C. T. ; Narendran, Parth ; Iqbal, Ahmed ; Gandhi, Rajiv ; Harris, Sophie ; Nagi, Dinesh ; Aziz, Umaira ; Karra, Efthimia ; Ghosh, Sandip ; Hanif, Wasim ; Edwards, Amy E. ; Zafar, Mansoor ; Dashora, Umesh ; Várnai, Kinga A. ; Davies, Jim ; Wild, Sarah H. ; Wilmot, Emma G. ; Webb, David ; Khunti, Kamlesh ; Rea, Rustam ; ABCD Covid-19 audit group ; on behalf of the ABCD Covid-19 audit group</creatorcontrib><description>Aims/hypothesis
The aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK.
Methods
A retrospective cohort study was performed using data collected through a nationwide audit of people admitted to hospital with diabetes and COVID-19, conducted by the Association of British Clinical Diabetologists from March to October 2020. Prespecified demographic, clinical, medication and laboratory data were collected from the electronic and paper medical record systems of the participating hospitals by local clinicians. The primary outcome of the study, severe COVID-19, was defined as death in hospital and/or admission to the adult intensive care unit (AICU). Logistic regression models were used to generate age-adjusted ORs.
Results
Forty UK centres submitted data. The final dataset included 196 adults who were admitted to hospital and had both type 1 diabetes and COVID-19 on admission (male sex 55%, white 70%, with mean [SD] age 62 [19] years, BMI 28.3 [7.3] kg/m
2
and last recorded HbA
1c
76 [31] mmol/mol [9.1 (5.0)%]). The prevalence of pre-existing microvascular disease and macrovascular disease was 56% and 39%, respectively. The prevalence of diabetic ketoacidosis on admission was 29%. A total of 68 patients (35%) died or were admitted to AICU. The proportions of people that died were 7%, 38% and 38% of those aged <55, 55–74 and ≥75 years, respectively. BMI, serum creatinine levels and having one or more microvascular complications were positively associated with the primary outcome after adjusting for age.
Conclusions/interpretation
In people with type 1 diabetes and COVID-19 who were admitted to hospital in the UK, higher BMI, poorer renal function and presence of microvascular complications were associated with greater risk of death and/or admission to AICU. Risk of severe COVID-19 is reassuringly very low in people with type 1 diabetes who are under 55 years of age without microvascular or macrovascular disease.
In people with Type 1 diabetes and COVID-19 admitted to hospital in the UK, BMI and one or more microvascular complications had a positive association and low serum creatine levels had a negative association with death/admission to intensive care unit after adjusting for age.</description><identifier>ISSN: 0012-186X</identifier><identifier>EISSN: 1432-0428</identifier><identifier>DOI: 10.1007/s00125-021-05463-x</identifier><identifier>PMID: 33966090</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Coronaviruses ; COVID-19 ; Creatine ; Creatinine ; Death ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetic ketoacidosis ; Human Physiology ; Intensive care ; Internal Medicine ; Ketoacidosis ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Microvasculature ; Regression analysis ; Renal function ; Risk factors</subject><ispartof>Diabetologia, 2021-08, Vol.64 (8), p.1717-1724</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-7f5c0b4d9b008309cf1350be34f46f1362cceaa4f11107ad7656e8c62435bca13</citedby><cites>FETCH-LOGICAL-c474t-7f5c0b4d9b008309cf1350be34f46f1362cceaa4f11107ad7656e8c62435bca13</cites><orcidid>0000-0001-6515-8325</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00125-021-05463-x$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00125-021-05463-x$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33966090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ruan, Yue</creatorcontrib><creatorcontrib>Ryder, Robert E. J.</creatorcontrib><creatorcontrib>De, Parijat</creatorcontrib><creatorcontrib>Field, Benjamin C. T.</creatorcontrib><creatorcontrib>Narendran, Parth</creatorcontrib><creatorcontrib>Iqbal, Ahmed</creatorcontrib><creatorcontrib>Gandhi, Rajiv</creatorcontrib><creatorcontrib>Harris, Sophie</creatorcontrib><creatorcontrib>Nagi, Dinesh</creatorcontrib><creatorcontrib>Aziz, Umaira</creatorcontrib><creatorcontrib>Karra, Efthimia</creatorcontrib><creatorcontrib>Ghosh, Sandip</creatorcontrib><creatorcontrib>Hanif, Wasim</creatorcontrib><creatorcontrib>Edwards, Amy E.</creatorcontrib><creatorcontrib>Zafar, Mansoor</creatorcontrib><creatorcontrib>Dashora, Umesh</creatorcontrib><creatorcontrib>Várnai, Kinga A.</creatorcontrib><creatorcontrib>Davies, Jim</creatorcontrib><creatorcontrib>Wild, Sarah H.</creatorcontrib><creatorcontrib>Wilmot, Emma G.</creatorcontrib><creatorcontrib>Webb, David</creatorcontrib><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Rea, Rustam</creatorcontrib><creatorcontrib>ABCD Covid-19 audit group</creatorcontrib><creatorcontrib>on behalf of the ABCD Covid-19 audit group</creatorcontrib><title>A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection</title><title>Diabetologia</title><addtitle>Diabetologia</addtitle><addtitle>Diabetologia</addtitle><description>Aims/hypothesis
The aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK.
Methods
A retrospective cohort study was performed using data collected through a nationwide audit of people admitted to hospital with diabetes and COVID-19, conducted by the Association of British Clinical Diabetologists from March to October 2020. Prespecified demographic, clinical, medication and laboratory data were collected from the electronic and paper medical record systems of the participating hospitals by local clinicians. The primary outcome of the study, severe COVID-19, was defined as death in hospital and/or admission to the adult intensive care unit (AICU). Logistic regression models were used to generate age-adjusted ORs.
Results
Forty UK centres submitted data. The final dataset included 196 adults who were admitted to hospital and had both type 1 diabetes and COVID-19 on admission (male sex 55%, white 70%, with mean [SD] age 62 [19] years, BMI 28.3 [7.3] kg/m
2
and last recorded HbA
1c
76 [31] mmol/mol [9.1 (5.0)%]). The prevalence of pre-existing microvascular disease and macrovascular disease was 56% and 39%, respectively. The prevalence of diabetic ketoacidosis on admission was 29%. A total of 68 patients (35%) died or were admitted to AICU. The proportions of people that died were 7%, 38% and 38% of those aged <55, 55–74 and ≥75 years, respectively. BMI, serum creatinine levels and having one or more microvascular complications were positively associated with the primary outcome after adjusting for age.
Conclusions/interpretation
In people with type 1 diabetes and COVID-19 who were admitted to hospital in the UK, higher BMI, poorer renal function and presence of microvascular complications were associated with greater risk of death and/or admission to AICU. Risk of severe COVID-19 is reassuringly very low in people with type 1 diabetes who are under 55 years of age without microvascular or macrovascular disease.
In people with Type 1 diabetes and COVID-19 admitted to hospital in the UK, BMI and one or more microvascular complications had a positive association and low serum creatine levels had a negative association with death/admission to intensive care unit after adjusting for age.</description><subject>Age</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Creatine</subject><subject>Creatinine</subject><subject>Death</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetic ketoacidosis</subject><subject>Human Physiology</subject><subject>Intensive care</subject><subject>Internal Medicine</subject><subject>Ketoacidosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Microvasculature</subject><subject>Regression analysis</subject><subject>Renal function</subject><subject>Risk factors</subject><issn>0012-186X</issn><issn>1432-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1v1DAQhi0EotuFP8ABWeLCxTD-iJNckKqFQkWlXijiZjnOpOsqG4fYabv_Hi8p5ePAySO9z7yemZeQFxzecIDybQTgomAgOINCacnuHpEVV1IwUKJ6TFYHnfFKfzsixzFeA4DM3FNyJGWtNdSwIvaEXn6mg00-DLe-RRrT3O5p6OiIYeyR3vq0pWk_IuW09bbBhJHadudTwpamQLchjj7ZfiE3F1_P3jNeUz906A6uz8iTzvYRn9-_a3J5-uHL5hM7v_h4tjk5Z06VKrGyKxw0qq0bgEpC7TouC2hQqk7pXGvhHFqrOs45lLYtdaGxclooWTTOcrkm7xbfcW522Doc0mR7M05-Z6e9Cdabv5XBb81VuDEVB13ks63J63uDKXyfMSaz89Fh39sBwxyNKISqKqlUmdFX_6DXYZ6GvF6mlC4rUdeHicRCuSnEOGH3MAwHc0jQLAmanKD5maC5y00v_1zjoeVXZBmQCxCzNFzh9Pvv_9j-ANC7ps8</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Ruan, Yue</creator><creator>Ryder, Robert E. J.</creator><creator>De, Parijat</creator><creator>Field, Benjamin C. T.</creator><creator>Narendran, Parth</creator><creator>Iqbal, Ahmed</creator><creator>Gandhi, Rajiv</creator><creator>Harris, Sophie</creator><creator>Nagi, Dinesh</creator><creator>Aziz, Umaira</creator><creator>Karra, Efthimia</creator><creator>Ghosh, Sandip</creator><creator>Hanif, Wasim</creator><creator>Edwards, Amy E.</creator><creator>Zafar, Mansoor</creator><creator>Dashora, Umesh</creator><creator>Várnai, Kinga A.</creator><creator>Davies, Jim</creator><creator>Wild, Sarah H.</creator><creator>Wilmot, Emma G.</creator><creator>Webb, David</creator><creator>Khunti, Kamlesh</creator><creator>Rea, Rustam</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6515-8325</orcidid></search><sort><creationdate>20210801</creationdate><title>A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection</title><author>Ruan, Yue ; Ryder, Robert E. J. ; De, Parijat ; Field, Benjamin C. T. ; Narendran, Parth ; Iqbal, Ahmed ; Gandhi, Rajiv ; Harris, Sophie ; Nagi, Dinesh ; Aziz, Umaira ; Karra, Efthimia ; Ghosh, Sandip ; Hanif, Wasim ; Edwards, Amy E. ; Zafar, Mansoor ; Dashora, Umesh ; Várnai, Kinga A. ; Davies, Jim ; Wild, Sarah H. ; Wilmot, Emma G. ; Webb, David ; Khunti, Kamlesh ; Rea, Rustam</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-7f5c0b4d9b008309cf1350be34f46f1362cceaa4f11107ad7656e8c62435bca13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>Creatine</topic><topic>Creatinine</topic><topic>Death</topic><topic>Diabetes</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetic ketoacidosis</topic><topic>Human Physiology</topic><topic>Intensive care</topic><topic>Internal Medicine</topic><topic>Ketoacidosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Microvasculature</topic><topic>Regression analysis</topic><topic>Renal function</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ruan, Yue</creatorcontrib><creatorcontrib>Ryder, Robert E. J.</creatorcontrib><creatorcontrib>De, Parijat</creatorcontrib><creatorcontrib>Field, Benjamin C. T.</creatorcontrib><creatorcontrib>Narendran, Parth</creatorcontrib><creatorcontrib>Iqbal, Ahmed</creatorcontrib><creatorcontrib>Gandhi, Rajiv</creatorcontrib><creatorcontrib>Harris, Sophie</creatorcontrib><creatorcontrib>Nagi, Dinesh</creatorcontrib><creatorcontrib>Aziz, Umaira</creatorcontrib><creatorcontrib>Karra, Efthimia</creatorcontrib><creatorcontrib>Ghosh, Sandip</creatorcontrib><creatorcontrib>Hanif, Wasim</creatorcontrib><creatorcontrib>Edwards, Amy E.</creatorcontrib><creatorcontrib>Zafar, Mansoor</creatorcontrib><creatorcontrib>Dashora, Umesh</creatorcontrib><creatorcontrib>Várnai, Kinga A.</creatorcontrib><creatorcontrib>Davies, Jim</creatorcontrib><creatorcontrib>Wild, Sarah H.</creatorcontrib><creatorcontrib>Wilmot, Emma G.</creatorcontrib><creatorcontrib>Webb, David</creatorcontrib><creatorcontrib>Khunti, Kamlesh</creatorcontrib><creatorcontrib>Rea, Rustam</creatorcontrib><creatorcontrib>ABCD Covid-19 audit group</creatorcontrib><creatorcontrib>on behalf of the ABCD Covid-19 audit group</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ruan, Yue</au><au>Ryder, Robert E. J.</au><au>De, Parijat</au><au>Field, Benjamin C. T.</au><au>Narendran, Parth</au><au>Iqbal, Ahmed</au><au>Gandhi, Rajiv</au><au>Harris, Sophie</au><au>Nagi, Dinesh</au><au>Aziz, Umaira</au><au>Karra, Efthimia</au><au>Ghosh, Sandip</au><au>Hanif, Wasim</au><au>Edwards, Amy E.</au><au>Zafar, Mansoor</au><au>Dashora, Umesh</au><au>Várnai, Kinga A.</au><au>Davies, Jim</au><au>Wild, Sarah H.</au><au>Wilmot, Emma G.</au><au>Webb, David</au><au>Khunti, Kamlesh</au><au>Rea, Rustam</au><aucorp>ABCD Covid-19 audit group</aucorp><aucorp>on behalf of the ABCD Covid-19 audit group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection</atitle><jtitle>Diabetologia</jtitle><stitle>Diabetologia</stitle><addtitle>Diabetologia</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>64</volume><issue>8</issue><spage>1717</spage><epage>1724</epage><pages>1717-1724</pages><issn>0012-186X</issn><eissn>1432-0428</eissn><abstract>Aims/hypothesis
The aim of this work was to describe the clinical characteristics of adults with type 1 diabetes admitted to hospital and the risk factors associated with severe coronavirus disease-2019 (COVID-19) in the UK.
Methods
A retrospective cohort study was performed using data collected through a nationwide audit of people admitted to hospital with diabetes and COVID-19, conducted by the Association of British Clinical Diabetologists from March to October 2020. Prespecified demographic, clinical, medication and laboratory data were collected from the electronic and paper medical record systems of the participating hospitals by local clinicians. The primary outcome of the study, severe COVID-19, was defined as death in hospital and/or admission to the adult intensive care unit (AICU). Logistic regression models were used to generate age-adjusted ORs.
Results
Forty UK centres submitted data. The final dataset included 196 adults who were admitted to hospital and had both type 1 diabetes and COVID-19 on admission (male sex 55%, white 70%, with mean [SD] age 62 [19] years, BMI 28.3 [7.3] kg/m
2
and last recorded HbA
1c
76 [31] mmol/mol [9.1 (5.0)%]). The prevalence of pre-existing microvascular disease and macrovascular disease was 56% and 39%, respectively. The prevalence of diabetic ketoacidosis on admission was 29%. A total of 68 patients (35%) died or were admitted to AICU. The proportions of people that died were 7%, 38% and 38% of those aged <55, 55–74 and ≥75 years, respectively. BMI, serum creatinine levels and having one or more microvascular complications were positively associated with the primary outcome after adjusting for age.
Conclusions/interpretation
In people with type 1 diabetes and COVID-19 who were admitted to hospital in the UK, higher BMI, poorer renal function and presence of microvascular complications were associated with greater risk of death and/or admission to AICU. Risk of severe COVID-19 is reassuringly very low in people with type 1 diabetes who are under 55 years of age without microvascular or macrovascular disease.
In people with Type 1 diabetes and COVID-19 admitted to hospital in the UK, BMI and one or more microvascular complications had a positive association and low serum creatine levels had a negative association with death/admission to intensive care unit after adjusting for age.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33966090</pmid><doi>10.1007/s00125-021-05463-x</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6515-8325</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetologia, 2021-08, Vol.64 (8), p.1717-1724 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8106514 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Age Coronaviruses COVID-19 Creatine Creatinine Death Diabetes Diabetes mellitus (insulin dependent) Diabetic ketoacidosis Human Physiology Intensive care Internal Medicine Ketoacidosis Medicine Medicine & Public Health Metabolic Diseases Microvasculature Regression analysis Renal function Risk factors |
| title | A UK nationwide study of people with type 1 diabetes admitted to hospital with COVID-19 infection |
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