New Study Shows Greater Risk for Severe COVID-19 Among People with Diabetes
By Eliza Skoler
New results from the CORONADO study reveal that one in five people with COVID-19 and diabetes die within 28 days of hospital admission. The main predictors of severe illness are older age and diabetes complications.
In May, the CORONADO study revealed that one in ten people with COVID-19 and diabetes died within seven days of hospital admission. Read our early article on the study here. New findings from the same study show that one in five people with COVID-19 and diabetes died within 28 days of hospital admission.
In the spring of 2020, the study followed 2,796 people with diabetes in France for 28 days after being admitted to the hospital for COVID-19. The analysis looked at rates of death and rates of discharge from the hospital during the 28-day period. The results revealed that after 28 days, 50% of individuals had been discharged and 21% of individuals had died (29% were still hospitalized). The analysis also looked at other factors in the study population:
Average age was 70 years old
About 40% had long-term microvascular (such as eye or kidney) or macrovascular (such as heart or leg) complications; 11% had heart failure
78% had high blood pressure
Almost two thirds were men
88% had type 2 diabetes, and 12% had type 1 diabetes
Older age, diabetes complications (especially heart disease and high blood pressure), difficulty breathing, use of anticoagulant (blood thinning) medication, and biological markers of inflammation were associated with a lower chance of hospital discharge. Similarly, older age, longer duration of diabetes, and a history of microvascular complications were associated with severe illness and poor outcomes from COVID-19 infection. On the other hand, younger age and metformin use were associated with leaving the hospital by the end of 28 days. As discussed in a previous article, while metformin use was associated with a more favorable health outcome, it was not shown to cause better health. Overall, the factors associated with death were the mirror-opposite of those associated with hospital discharge.
Long-term blood sugar management (measured by A1C) was not found to affect COVID-19 outcomes, though high plasma glucose levels at the time of hospitalization were strongly associated with death. Because glucose levels may be tied to COVID-19 outcomes, careful diabetes management remains important for preventing severe illness.
People with diabetes do not have a higher risk of getting COVID; rather, they are more likely to experience severe illness and worse outcomes if infected with COVID-19. It remains important for people with diabetes, as well as their contacts and loved ones, to do everything possible to stay healthy and safe: get vaccinated as soon as you can, continue to social distance, and wear one (or two!) masks in public. To learn more, read “What You Should Know About COVID-19 Vaccines and Diabetes” and “COVID Variants, Double Masks, Diabetes, Oh My!”