Age and use of certain medications are among the factors that affect the risk for severe COVID-19 in people with diabetes, according to new research presented at the American Association of Clinical Endocrinology Annual Scientific and Clinical Conference, and reported in a Healio article.
It has long been known that blood glucose control is a key factor in outcomes related to COVID-19 in people with diabetes — both before people are admitted to the hospital for the viral infection, and during their hospital stay. For the latest study, researchers set out to look more broadly at factors related to poor outcomes in people with diabetes who were hospitalized for COVID-19. While severe COVID-19 is often generally defined as any infection that requires hospitalization, for this study, it was defined more narrowly within the group of hospitalized patients to mean being admitted to the intensive care unit (ICU), meeting certain criteria for reduced ability to breathe, or death.
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Certain factors linked to severe COVID-19
A total of 1,818 people with diabetes who were hospitalized for COVID-19 at various locations were included in the study. The researchers found that within this group, many different factors were linked to a higher or lower risk for severe COVID-19. Factors that increased the risk of severe COVID-19 included older age, being male (37% higher risk), having a body-mass index (BMI, a measure of weight that takes height into account) over 35 (83% higher risk), having neuropathy (65% higher), and having cardiovascular disease (30% higher). Taking either of two types of prescription drugs prior to hospitalization was also linked to a higher risk for severe COVID-19 — steroids (49% higher risk) and the type 2 diabetes drugs SGLT2 inhibitors (85% higher risk). Two other types of drugs were linked to a lower risk for severe COVID-19 — blood-pressure-lowering ACE inhibitors (25% lower risk) and cholesterol-lowering statins (34% lower risk).
The higher risk for severe COVID-19 linked to taking steroids before hospitalization may be surprising to many people, since corticosteroids are one of the key treatments used for people who are critically ill with COVID-19 once they are hospitalized. And the higher risk linked to SGlT2 inhibitors may be especially alarming, since these drugs have been shown to have benefits beyond blood glucose control, including improving kidney function in people with diabetes. This results indicate that it may be especially important for people who take these drugs to take all possible steps to avoid COVID-19 infection.
The researchers noted that as the COVID-19 pandemic continues despite ongoing vaccinations, further research may help determine whether people with diabetes who are at higher risk for severe COVID-19 during hospitalization may benefit from earlier interventions, such as earlier intensive care or early access to certain treatments.
Want to learn more about coronavirus and diabetes? Read our latest COVID-19 updates.