How does diabetes affect mortality risk for coronavirus disease 2019 (COVID-19)?

Updated: Apr 30, 2021
  • Author: David J Cennimo, MD, FAAP, FACP, AAHIVS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Type 1 and type 2 diabetes are both independently associated with a significant increased odds of in-hospital death with COVID-19. A nationwide analysis in England of 61,414,470 individuals in the registry alive as of February 19, 2020, 0.4% had a recorded diagnosis of type 1 diabetes and 4.7% of type 2 diabetes. A total of 23,804 COVID-19 deaths in England were reported as of May 11, 2020, one-third were in people with diabetes, including 31.4% with type 2 diabetes and 1.5% with type 1 diabetes. Upon multivariate adjustment, the odds of in-hospital COVID-19 death were 3.5 for those with type 1 diabetes and 2.03 for those with type 2 diabetes, compared with deaths without known diabetes. Further adjustment for cardiovascular comorbidities found the odds ratios were still significantly elevated in both type 1 (2.86) and type 2 (1.81) diabetes. [79]

The CDC estimates diabetes is associated with a 20% increased odds of in-hospital mortality. [50]

Hospitalization and cardiometabolic conditions 

O’Hearn et al estimate nearly 2 in 3 adults hospitalized for COVID-19 in the US have associated cardiometabolic conditions including total obesity (BMI 30 kg/m2 or greater), diabetes mellitus, hypertension, and heart failure. [80]  

 


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