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Risk Factors ID'd for COVID-19-Related Death in Diabetes

MONDAY, May 3, 2021 -- For individuals with diabetes, the risk for COVID-19-related death is increased in association with male sex, older age, preexisting comorbidities, and use of insulin, according to a review published online April 28 in Diabetologia.

Sabrina Schlesinger, Ph.D., from the Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf in Germany, and colleagues conducted a living systematic review and meta-analysis on observational studies investigating phenotypes in individuals with diabetes and COVID-19-related death and severity. Summary relative risks (SRRs) were calculated using a random effects meta-analysis.

Twenty-two articles with 17,687 individuals met the inclusion criteria. The researchers found that among individuals with diabetes and COVID-19, for COVID-19-related death, there was high-to-moderate certainty of evidence for associations with male sex (SRR, 1.28), older age (>65 years: SRR, 3.49), preexisting comorbidities (SRRs, 1.56, 1.93, and 1.40 for cardiovascular disease, chronic kidney disease, and chronic obstructive pulmonary disease, respectively), diabetes treatment (SRRs, 1.75 and 0.50 for insulin use and metformin use, respectively), and blood glucose at admission (≥11 mmol/L: SRR, 8.60). Between risk phenotypes of diabetes and severity of COVID-19, similar but generally weaker and less precise associations were observed.

"The risk group we identified for the population with diabetes and COVID-19, i.e., older individuals with comorbid conditions and using insulin, might simply reflect severity of diabetes or poor health conditions per se," the authors write. "Nevertheless, considering these phenotypes can be helpful for identifying people with diabetes and COVID-19 at high risk for poor outcomes."

Two authors disclosed financial ties to the pharmaceutical industry.

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