COVID-19 Hospitalization in Adults with Type 1 Diabetes: Results from the T1D Exchange Multicenter Surveillance Study

• Published in: The journal of clinical endocrinology and metabolism Vol. 106; no. 2; pp. e936 - e942
• Main Authors: O’Malley, Grenye, Ebekozien, Osagie, Desimone, Marisa, Pinnaro, Catherina T, Roberts, Alissa, Polsky, Sarit, Noor, Nudrat, Aleppo, Grazia, Basina, Marina, Tansey, Michael, Steenkamp, Devin, Vendrame, Francesco, Lorincz, Ilona, Mathias, Priyanka, Agarwal, Shivani, Golden, Lauren, Hirsch, Irl B, Levy, Carol J
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.02.2021; Copyright Oxford University Press
• Subjects: Adult; Adults; Age; Aged; Aged, 80 and over; Analysis; Blood sugar monitoring; Comorbidity; COVID-19; COVID-19 - complications; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 - therapy; Cross-Sectional Studies; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 1 - therapy; Female; Glucose monitoring; Glycosylated hemoglobin; Health care access; Health surveys; Hemoglobin; Hospitalization; Hospitalization - statistics & numerical data; Humans; Male; Medical equipment and supplies industry; Medical test kit industry; Middle Aged; Morbidity; Pandemics; Population studies; Population Surveillance; Prognosis; Regression analysis; Retrospective Studies; Risk factors; SARS-CoV-2 - physiology; Treatment Outcome; Type 1 diabetes; United States - epidemiology; Young Adult; United States; COVID-19; type 1 diabetes; hospitalization; adult
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgaa825

Abstract Context Diabetes mellitus is associated with increased COVID-19 morbidity and mortality, but there are few data focusing on outcomes in people with type 1 diabetes. Objective The objective of this study was to analyze characteristics of adults with type 1 diabetes for associations with COVID-19 hospitalization. Design An observational multisite cross-sectional study was performed. Diabetes care providers answered a 33-item questionnaire regarding demographics, symptoms, and diabetes- and COVID-19-related care and outcomes. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between glycated hemoglobin (HbA1c), age, and comorbidities and hospitalization. Setting Cases were submitted from 52 US sites between March and August 2020. Patients or Other Participants Adults over the age of 19 with type 1 diabetes and confirmed COVID-19 infection were included. Interventions None. Main Outcome Measures Hospitalization for COVID-19 infection. Results A total of 113 cases were analyzed. Fifty-eight patients were hospitalized, and 5 patients died. Patients who were hospitalized were more likely to be older, to identify as non-Hispanic Black, to use public insurance, or to have hypertension, and less likely to use continuous glucose monitoring or insulin pumps. Median HbA1c was 8.6% (70 mmol/mol) and was positively associated with hospitalization (odds ratio 1.42, 95% confidence interval 1.18-1.76), which persisted after adjustment for age, sex, race, and obesity. Conclusions Baseline glycemic control and access to care are important modifiable risk factors which need to be addressed to optimize care of people with type 1 diabetes during the worldwide COVID-19 pandemic.