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open access

Vol 73, No 1 (2022)
Original paper
Submitted: 2021-11-30
Accepted: 2021-12-09
Published online: 2022-01-31
View PDF Download PDF file Supp./Additional Files [1]
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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
DOI: 10.5603/EP.a2022.0008
·
Pubmed: 35119089
·
Endokrynol Pol 2022;73(1):87-95.
Affiliations
  1. University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Türkiye
  2. University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Ankara, Türkiye
  3. Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Türkiye
  4. The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Türkiye
  5. Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Türkiye
  6. Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Türkiye
  7. Ministry of Health, Department of Strategy Development, Ankara, Türkiye
  8. Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Türkiye
  9. University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Türkiye
  10. Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Türkiye
  11. Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Türkiye
  12. University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Türkiye
  13. Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Izmir, Türkiye
  14. Ankara Provincial Health Directorate, Ankara, Türkiye
  15. Medica Clinic, Endocrinology and Metabolism, Istanbul, Türkiye
  16. Deputy Minister of Health, Ministry of Health, Ankara, Türkiye
  17. University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Türkiye

open access

Vol 73, No 1 (2022)
Original Paper
Submitted: 2021-11-30
Accepted: 2021-12-09
Published online: 2022-01-31

Abstract

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.

Abstract

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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Keywords

COVID-19; coronavirus; type 1 diabetes; mortality; diabetes mellitus; T1DM; Turkey

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About this article
Title

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

Journal

Endokrynologia Polska

Issue

Vol 73, No 1 (2022)

Article type

Original paper

Pages

87-95

Published online

2022-01-31

Page views

6049

Article views/downloads

664

DOI

10.5603/EP.a2022.0008

Pubmed

35119089

Bibliographic record

Endokrynol Pol 2022;73(1):87-95.

Keywords

COVID-19
coronavirus
type 1 diabetes
mortality
diabetes mellitus
T1DM
Turkey

Authors

Ibrahim Demirci
Cem Haymana
Ilker Tasci
Ilhan Satman
Aysegul Atmaca
Mustafa Sahin
Naim Ata
Ugur Unluturk
Erman Cakal
Selcuk Dagdelen
Ibrahim Sahin
Osman Celik
Derun Ertugrul
Tevfik Demir
Rifat Emral
Murat Caglayan
Serpil Salman
Suayip Birinci
Alper Sonmez

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