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- Title
Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity.
- Authors
Diedisheim, Marc; Dancoisne, Etienne; Gautier, Jean-François; Larger, Etienne; Cosson, Emmanuel; Fève, Bruno; Chanson, Philippe; Czernichow, Sébastien; Tatulashvili, Sopio; Raffin-Sanson, Marie-Laure; Sallah, Kankoé; Bourgeon, Muriel; Ajzenberg, Christiane; Hartemann, Agnès; Daniel, Christel; Moreau, Thomas; Roussel, Ronan; Potier, Louis
- Abstract
<bold>Context: </bold>Diabetes is reported as a risk factor for severe COVID-19, but whether this risk is similar in all categories of age remains unclear.<bold>Objective: </bold>To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories.<bold>Design Setting and Participants: </bold>We conducted a retrospective observational cohort study of 6,314 consecutive patients hospitalized for COVID-19 between February and June 30 2020, and follow-up recorded until 30 September 2020, in the Paris metropolitan area, France.<bold>Main Outcome Measure(s): </bold>The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories.<bold>Results: </bold>Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (HR 1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, p<0.001), but adjusted HR for diabetes was significant only in patients under 50 (HR 1.81 [1.14-2.87]).<bold>Conclusions: </bold>Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
- Subjects
COVID-19; COVID-19 pandemic; YOUNG adults; MEDICAL research; OLDER people; CARDIOVASCULAR diseases
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 9, pe3364
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab393