EYES2022 ESE Young Endocrinologists and Scientists (EYES) 2022 Diabetes, Obesity, Metabolism and Nutrition (9 abstracts)
1University of Modena and Reggio Emilia, Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences; 2Azienda Ospedaliero-Universitaria of Modena, Department of Medical Specialties; 3Azienda USL of Modena, Department of Laboratory Medicine and Pathology; 4University of Modena and Reggio Emilia, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences; 5University of California Berkeley, School of Public Health
Background: Diabetes mellitus (DM) prevalence in patients with severe acute respiratory coronavirus virus (SARS-CoV-2) infection differs among studies, although pre-existing DM seems to double the risk of critical infection and mortality.
Objectives: To evaluate incidence and mortality risk of SARS-CoV-2 infection in a large diabetic population in Northern Italy in pre-vaccine era.
Methods: Retrospective, observational, big data study including non-vaccinated subjects with type 1 and type 2 DM in the Province of Modena, submitted to at least 1 swab for SARS-CoV-2 between March 2020 and March 2021.
Results: SARS-CoV-2 infection was detected in 2302 of 9553 diabetic patients (24.1%) with death in 8.9% of cases. No difference in SARS-CoV-2 prevalence was detected considering sex, whereas youngest people showed highest SARS-CoV-2 infection rate. DM duration was shorter in infected than uninfected patients (P < 0.001), but HbA1c was higher in infected compared to uninfected patients (P < 0.001). Accordingly, SARS-CoV-2 was less frequent in patients treated with anti-diabetic drugs compared to those not treated (P < 0.001). SARS-CoV-2 infection was predicted by age (OR 1.013, 95%CI:1.008-1.017), DM duration (OR 1.007, 95%CI:1.001-1.013), and HbA1c (OR 1.009, 95%CI:1.002-1.016). COVID-19 mortality was predicted by DM duration (OR 1.010, 95%CI: 1.005-1.015) and HbA1c (OR 1.005, 95%CI:1.002-1.009). At ROC analyses with death as test variable, worse prognosis was predicted by DM duration longer than 10.9 years (AUC=0.639, 95%CI:0.6010.676) and age older than 74.4 years (AUC=0.797, 95%CI:0.7670.827).
Conclusion: Our study confirms the correlation between SARS-CoV-2 related mortality and DM. Although SARS-CoV-2 infection was more frequent in the younger patients, a poor glycemic control worsens outcomes, especially in older diabetic people with long DM duration. Patients with DM and SARS-CoV-2 should be followed carefully when older than 74 years and with long DM duration.