Diabetes and COVID-19 Outcomes: An Analysis of Freeman Health System Patients

被引:0
作者
Wiant, Timothy [1 ]
Schmidt, Logan [1 ]
Srikakolapu, Saibhavana [2 ]
Beyersdorfer, Nova [2 ]
Akhtar, Mariam [2 ]
Johnson, Kerry [3 ]
Stahl, Greg [2 ]
Goade, Darrin S. [4 ]
Arnce, Robert D. [2 ]
机构
[1] Kansas City Univ, Coll Med, Kansas City, MO 64106 USA
[2] Kansas City Univ, Coll Med, Joplin, MO USA
[3] Missouri Southern State Univ, Math, Joplin, MO 64801 USA
[4] Freeman Hlth Syst, Pharmacy, Joplin, MO USA
关键词
type 1 and type 2 diabetes mellitus; mortality; rural population; diabetes; covid-19; COVERAGE; TYPE-1; URBAN;
D O I
10.7759/cureus.54249
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: As COVID-19 continues to affect millions of people around the world, it has become vital to understand how comorbidities such as diabetes affect the health outcomes of these patients. While earlier studies have focused on major metropolitan areas, rural settings have been comparatively understudied. The goal of this study is to understand the effect on mortality that these two diseases have in the inpatient setting of a rural population. Methods: The electronic medical records of all adult patients admitted to Freeman Health System, Joplin, Missouri, United States, between April 1, 2020, and December 31, 2021, were reviewed for the presence of COVID-19 infection and/or diabetes (type I and type II). Freeman Health is a major health system headquartered in Southwest Missouri. Diagnoses were obtained through the use of standard International Classification of Disease, 10th edition (ICD-10) codes. The initial data set consisted of 19,323 admissions. After excluding duplicate admissions and those who had already been infected with COVID-19, 1,729 patients with COVID-19, 172 patients with type I diabetes, and 3,992 patients with type II diabetes were included in the analysis of inpatient all -cause mortality. We hypothesized that patients with type I and type II diabetes would both show an increased risk of all -cause mortality. Mortality in the context of our study results refers to all -cause mortality. Results: The all -cause mortality rate was 19.94% (137/687, with a 95% confidence interval (CI) of 16.95%22.93%) in patients admitted with both diabetes (the combined type I and type II subsets) and COVID-19 (P1). The mortality rate was 16.03% (167/1042, with 95% CI of 13.80%-18.25%) in patients admitted with COVID-19 who did not have diabetes (P2). Patients admitted with a comorbid diagnosis of diabetes but without COVID-19 (P5) had a much lower mortality rate of 5.98% (249/4164, with a 95% CI of 5.26%-6.70%). The combination of both COVID-19 and diabetes together was associated with a higher mortality rate than either of the two separately. The mortality rate was additionally elevated in patients with both type II diabetes and COVID-19 (P4) (134/663, mortality rate of 20.21% with 95% CI of 17.15%-23.27%) versus those with COVID-19 without diabetes (P2) (167/1042, 16.03% with 95% CI of 13.80%-18.25%), an overall difference of 4.18% (95% CI of 0.40%-7.94%). The subset of patients with type I diabetes with COVID-19 (P3) and type I diabetes without COVID-19 (P6) were too small to accurately power individual analysis. The subset of patients with diabetes (type I and type II) and without COVID-19 (P5) had the lowest mortality rate of any subset adequately powered for analysis at 5.98% (249/41464, CI of 5.26%-6.70%). Conclusions: The results of this study show that type II diabetes is a significant risk factor for mortality in admitted COVID-19 patients. P4 had the highest overall mortality of any subset studied. The study was underpowered to show if type I diabetes patients, with and without COVID-19, had an increased mortality when analyzed separately. COVID-19 significantly increased mortality in all subsets adequately powered for full analysis.
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页数:10
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共 31 条
  • [1] [Anonymous], 2023, COVID Data Tracker
  • [2] [Anonymous], 2021, What You Need to Know: Getting a COVID-19 Vaccine
  • [3] [Anonymous], 2021, What Is Monoclonal Antibody Therapy & Who Is Eligible to Receive It?
  • [4] [Anonymous], 2023, Underlying Medical Conditions Associated with Higher Risk for Severe COVID- 19: Information for Healthcare Professionals
  • [5] COVID-19-related hyperglycemia is associated with infection of hepatocytes and stimulation of gluconeogenesis
    Barreto, Ester A.
    Cruz, Amanda S.
    Veras, Flavio P.
    Martins, Ronaldo
    Bernardelli, Rafaella S.
    Paiva, Isadora M.
    Lima, Thais M.
    Singh, Youvika
    Guimaraes, Raphael C.
    Damasceno, Samara
    Pereira, Nayara
    Alvesa, Joao Manoel
    Goncalves, Tiago T.
    Forato, Julia
    Muraro, Stefanie P.
    Souza, Gabriela F.
    Batah, Sabrina Setembre
    Proenca-Modena, Jose L.
    Mori, Marcelo A.
    Cunha, Fernando Q.
    Louzada-Junior, Paulo
    Cunha, Thiago M.
    Nakay, Helder I.
    Fabro, Alexandre
    de Oliveira, Rene D. R.
    Arruda, Eurico
    Rea, Rosangela
    Neto, Alvaro Rea
    da Silva, Miguel M. Fernandes
    Leiria, Luiz Osorio
    [J]. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2023, 120 (21)
  • [6] Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study
    Barron, Emma
    Bakhai, Chirag
    Kar, Partha
    Weaver, Andy
    Bradley, Dominique
    Ismail, Hassan
    Knighton, Peter
    Holman, Naomi
    Khunti, Kamlesh
    Sattar, Naveed
    Wareham, Nicholas J.
    Young, Bob
    Valabhji, Jonathan
    [J]. LANCET DIABETES & ENDOCRINOLOGY, 2020, 8 (10) : 813 - 822
  • [7] Impact of the COVID-19 pandemic on long-term trends in the prevalence of diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes: an international multicentre study based on data from 13 national diabetes registries
    Birkebaek, Niels H.
    Kamrath, Clemens
    Grimsmann, Julia M.
    Aakesson, Karin
    Cherubini, Valentino
    Dovc, Klemen
    de Beaufort, Carine
    Alonso, Guy T.
    Gregory, John W.
    White, Mary
    Skrivarhaug, Torild
    Sumnik, Zdenek
    Jefferies, Craig
    Hoertenhuber, Thomas
    Haynes, Aveni
    De Bock, Martin
    Svensson, Jannet
    Warner, Justin T.
    Gani, Osman
    Gesuita, Rosaria
    Schiaffini, Riccardo
    Hanas, Ragnar
    Rewers, Arleta
    Eckert, Alexander J.
    Holl, Reinhard W.
    Cinek, Ondrej
    [J]. LANCET DIABETES & ENDOCRINOLOGY, 2022, 10 (11) : 786 - 794
  • [8] Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States
    Bode, Bruce
    Garrett, Valerie
    Messler, Jordan
    McFarland, Raymie
    Crowe, Jennifer
    Booth, Robby
    Klonoff, David C.
    [J]. JOURNAL OF DIABETES SCIENCE AND TECHNOLOGY, 2020, 14 (04): : 813 - 821
  • [9] Diabetes is most important cause for mortality in COVID-19 hospitalized patients: Systematic review and meta-analysis
    Corona, Giovanni
    Pizzocaro, Alessandro
    Vena, Walter
    Rastrelli, Giulia
    Semeraro, Federico
    Isidori, Andrea M.
    Pivonello, Rosario
    Salonia, Andrea
    Sforza, Alessandra
    Maggi, Mario
    [J]. REVIEWS IN ENDOCRINE & METABOLIC DISORDERS, 2021, 22 (02) : 275 - 296
  • [10] Dynamics of the COVID-19 epidemic in urban and rural areas in the United States
    Cuadros, Diego F.
    Branscum, Adam J.
    Mukandavire, Zindoga
    Miller, F. DeWolfe
    MacKinnon, Neil
    [J]. ANNALS OF EPIDEMIOLOGY, 2021, 59 : 16 - 20