Table 1.
Clinical characteristics and outcomes in patients with diabetes mellitus and COVID-19
| Region | Study design | Age (years; mean or median) | Number (women/men) | Glycaemic status, HbA1c (%) (proportion) | Comorbidities (%) | Main findings | Ref. |
|---|---|---|---|---|---|---|---|
| Diabetes mellitus | |||||||
| France | Nationwide observational cohort study | 69.8 ± 13.0 | 1,317 (462/855) | 8.1 ± 1.9 |
HTN (77) CVD (41) HF (12) CKD (33) COPD (10) |
Primary outcome (MV, death on day 7): 29% Risk factors for primary outcome: BMI Risk factors for mortality: older age, microvascular and macrovascular complications |
45 |
| China | Retrospective cohort study | 64.0 (56.2–72.0) | 153 |
<7.0 (16%) 7.0–8.0 (13%) 8.0–9.0 (12%) >9.0 (24%) |
HTN (57) CVD (21) CKD (4) COPD (5) |
ICU admission: 18% (non-DM 8%) In-hospital death: 20% (non-DM 11%) Risk factors for mortality: age ≥70 years, HTN |
211 |
| USA | Retrospective cohort study | 66.7 ± 14.2 | 178 (68/110) | 8.1 ± 2.0 |
HTN (75) CHD (25) HF (16) CKD (26) COPD (26) |
ICU admission: OR 1.59 (95% CI 1.01–2.52)a MV: OR 1.97 (95% CI 1.21–3.20)a Mortality: OR 2.02 (95% CI 1.01–4.03)a |
212 |
| USA | Retrospective cohort study | 67.9 ± 13.7 | 1,276 (649/630) | 7.5 ± 2.0 |
HTN (91) CVD (59) CKD (43) COPD (14) |
Death: 33% Risk factors for mortality: insulin treatment before admission, COPD, male sex, older age, higher BMI |
213 |
| T1DM | |||||||
| UK (England) | Population-based cohort study | 46.6 ± 19.6 | 264,390 (114,710/ 149,680) |
<6.5 (7%) 6.5–7.0 (8%) 7.1–9.9 (50%) ≥10.0 (12%) |
HTN (SBP >140 mmHg (17); antihypertensive agents (44)) CKD (10) MI (1) Stroke (1) HF (3) |
COVID-19-related deaths: 464 Risk factors for mortality: male sex, older age, renal impairment, non-white ethnicity, socioeconomic deprivation, previous stroke, previous HF, HbA1c ≥10.0% (reference range 6.5–7.0%) BMI (U-shaped, reference range 25.0–29.9 kg/m2) |
11 |
| UK (England) | Whole population study | 46.6 ± 19.5 | 263,830 (114,495/ 149,330) | No glycaemic data |
CHD (10) CeVD (4) HF (3) |
COVID-19-related deaths: 364 72-day mortality: 138 (95% CI 124−153) per 100,000 people Mortalitya: OR 3.51 (95% CI 3.16−3.90) |
19 |
| France | Nationwide observational cohort study | 56.0 ± 16.4 | 56 (25/31) | 8.4 (7.6–9.5) |
Microvascular complications (49) Macrovascular complications (33) CKD (29) COPD (4) |
Primary outcome (MV, death on day 7): 23% (age <55 years 12%; 55–74 years 24%; ≥75 years 50%) | 141 |
| T2DM | |||||||
| China | Retrospective cohort study | 62 (55–68) | 952 (442/510) | Glucose 8.3 mmol/l (6.2–12.4 mmol/l) |
HTN (53) CHD (14) CeVD (6) CKD (5) COPD (1) |
Well-controlled versus poorly controlled T2DM All-cause mortality: HR 0.14 (95% CI 0.03–0.60) ARDS: HR 0.47 (95% CI 0.27–0.83) Acute kidney injury: HR 0.12 (95% CI 0.01–0.96) Acute heart injury: HR 0.24 (95% CI 0.08–0.71) |
18 |
| UK (England) | Population-based cohort study | 67.5 ± 13.4 | 2,874,020 (1,267,590/ 1,606,430) |
<6.5 (25%) 6.5–7.0 (21%) 7.1–7.5 (13%) 7.6–9.9 (25%) ≥10.0 (11%) |
HTN (SBP >140 mmHg (67); antihypertensive agents (76)) CKD (18) MI (2) stroke (2) HF (5) |
COVID-19-related deaths: 10,525 Risk factors for mortality: male sex, older age, renal impairment, non-white ethnicity, socioeconomic deprivation, previous stroke, previous HF, HbA1c ≥7.5% or <6.5% (reference range 6.5%–7.0%), BMI (U-shaped, reference range 25.0–29.9 kg/m2) |
11 |
| UK (England) | Whole population study | 67.4 ± 13.4 | 2,864,670 (1,263,615/ 1,601,045) | No glycaemic data |
CHD (19) CeVD (7) HF (6) |
COVID-19-related deaths: 7,434 72-day mortality: 260 (95% CI 254−264) per 100,000 people Mortalityb: OR 2.03 (95% CI 1.97−2.09) |
19 |
| China | Retrospective cohort study | 63.0 (56.0–69.0) | 1,213 (632/581) | Glucose 8.6 (6.5–12.5) mmol/l |
CHD (15) HF (0.2) CeVD (4) |
Metformin versus non-metformin Acidosis: HR 2.73 (95% CI 1.04−7.13) Lactic acidosis: HR 4.46 (95% CI 1.11−18.00) Mortality: HR 1.65 (95% CI 0.71−3.86) ARDS: HR 0.85 (95% CI 0.61−1.17) DIC: HR 1.68 (95% CI 0.26−10.90) Acute kidney injury: HR 0.65 (95% CI 0.19−2.24) Acute heart injury: HR 1.02 (95% CI 0.62−1.66) |
214 |
Major studies are included; for a more comprehensive list of studies, please refer to Supplementary Table 1. ARDS, acute respiratory distress syndrome; CeVD, cerebrovascular disease; CHD, coronary heart disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; CVD, cardiovascular disease; DIC, disseminated intravascular coagulation; DM, diabetes mellitus; HF, heart failure; HTN, hypertension; ICU, intensive care unit; MI, myocardial infarction; MV, mechanical ventilation; SBP, systolic blood pressure; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus. aDM versus non-DM. bT2DM versus non-DM.