Risk Factors for COVID-19 in Diabetics

Diabetes has been identified as a risk factor for poor prognosis among individuals with Covid19. Diabetes is a complex and heterogeneous disease and studies have shown that different phenotypes are associated differently with Covid19 complications and comorbidity. In this study, a systemic living review and meta-analysis is carried out to find the association of different diabetes phenotypes and confirmed SARS-CoV 2 infection with relation to Covid 19 death and severity.

Men had an increased risk of COVID 19-related death and severity when compared to women. In addition, older age (>65 years) was associated with a higher risk of COVID-19-related death. With each 5- year increase in age, the relative risk for COVID-19-related death increased by 43% and severity by 25%. Increased glucose levels at admission were associated with increased risk of COVID-19- related death and severity even in individuals without pre-existing diabetes.

Individuals with well-controlled diabetes had a better prognosis of COVID-19 compared with individuals with poorly controlled diabetes. Higher HbA1c, chronic insulin use, and Type I diabetes were associated with poor prognosis of COVID-19 in individuals. COPD was highly associated with increased risk in COVID-19 related death. Higher white blood cell (leucocyte) and neutrophil counts and lower lymphocyte counts also increased the relative risk for COVID 19-related death and COVID-19 severity.

The association of CKD and CVD was much lower with no clear associations for hypertension, cancer, any comorbidity, liver disease, dementia, statin use, and renin inhibitor use (including ACE inhibitors, angiotensin II receptor blockers, and nonspecified renin-angiotensin system [RAS] inhibitors), CRP and ALT and AST, LDH and albumin before admission with COVID-19 severity and/or COVID-19-related death.  Findings from this study show that diabetic phenotypes of men aged over 65, uncontrolled blood glucose levels and under chronic insulin usage, having comorbidities like COPD are highly associated COVID-19 related severity and death.

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Ref Link: DOI: 10.1007/s00125-021-05458-8