Vol 73, No 1 (2022)
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Published online: 2022-01-31

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Higher rate of COVID-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study

Ibrahim Demirci1, Cem Haymana1, Ilker Tasci2, Ilhan Satman34, Aysegul Atmaca5, Mustafa Sahin6, Naim Ata7, Ugur Unluturk8, Erman Cakal9, Selcuk Dagdelen8, Ibrahim Sahin10, Osman Celik11, Derun Ertugrul12, Tevfik Demir13, Rifat Emral6, Murat Caglayan14, Serpil Salman15, Suayip Birinci16, Alper Sonmez17
Pubmed: 35119089
Endokrynol Pol 2022;73(1):87-95.


Introduction: COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM.

Material and methods: A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality.

Results: The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41–7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28–6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01–1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04–25.5, p = 0.045) were independently associated with mortality in patients with T1DM.

Conclusions: Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.

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