Table 1.
Patient and health system characteristics for 116,370 adults with confirmed SARS-CoV-2 infection
| Characteristic | Overall | No diabetes | Type 1 diabetes | Type 2 diabetes |
|---|---|---|---|---|
| Total, No. | 116,370 | 93,098 | 802 | 22,470 |
| Age, years (median [IQR]) | 47.0 [32.0, 62.0] | 42.0 [30.0, 57.0] | 41.0 [29.0, 57.0] | 63.0 [53.0, 74.0] |
| Age categories, years, n (%) | ||||
| 18–29 | 23,187 (19.9) | 22,628 (24.3) | 207 (25.8) | 352 (1.6) |
| 30–39 | 20,102 (17.3) | 18,907 (20.3) | 174 (21.7) | 1,021 (4.5) |
| 40–49 | 19,345 (16.6) | 16,578 (17.8) | 136 (17.0) | 2,631 (11.7) |
| 50–59 | 19,853 (17.1) | 14,816 (15.9) | 110 (13.7) | 4,927 (21.9) |
| 60–69 | 15,300 (13.1) | 9,457 (10.2) | 92 (11.5) | 5,751 (25.6) |
| 70–79 | 10,380 (8.9) | 5,666 (6.1) | 53 (6.6) | 4,661 (20.7) |
| 80–89 | 8,160 (7.0) | 5,017 (5.4) | 30 (3.7) | 3,113 (13.9) |
| ≥90 | 43 (0.0) | 29 (0.0) | 0 (0.0) | 14 (0.1) |
| Gender, n (%) | ||||
| Female | 62,103 (53.4) | 50,365 (54.1) | 385 (48.0) | 11,353 (50.5) |
| Male | 53,888 (46.3) | 42,460 (45.6) | 413 (51.5) | 11,015 (49.0) |
| Unknown | 379 (0.3) | 273 (0.3) | 4 (0.5) | 102 (0.5) |
| Race/ethnicity, n (%) | ||||
| Non-Hispanic, White | 32,323 (27.8) | 25,165 (27.0) | 313 (39.0) | 6,845 (30.5) |
| Non-Hispanic, Black | 18,695 (16.1) | 13,903 (14.9) | 158 (19.7) | 4,634 (20.6) |
| Non-Hispanic, Other | 2,618 (2.2) | 2,204 (2.4) | 8 (1.0) | 406 (1.8) |
| Non-Hispanic, Unknown race | 1,649 (1.4) | 1,255 (1.3) | 21 (2.6) | 373 (1.7) |
| Hispanic | 50,553 (43.4) | 41,764 (44.9) | 245 (30.5) | 8,544 (38.0) |
| Asian or Pacific Islander | 2,362 (2.0) | 1,778 (1.9) | 14 (1.7) | 570 (2.5) |
| American Indian or Alaska Native | 1,777 (1.5) | 1,336 (1.4) | 13 (1.6) | 428 (1.9) |
| Unknown ethnicity, White | 1,846 (1.6) | 1,581 (1.7) | 12 (1.5) | 253 (1.1) |
| Unknown ethnicity, Black | 571 (0.5) | 477 (0.5) | 2 (0.2) | 92 (0.4) |
| Unknown ethnicity, Other race | 1,147 (1.0) | 959 (1.0) | 9 (1.1) | 179 (0.8) |
| Unknown ethnicity/Unknown race | 2,829 (2.4) | 2,676 (2.9) | 7 (0.9) | 146 (0.6) |
| BMI, kg/m2 (median [IQR]) | 29.3 [25.4, 34.5] | 29.0 [25.1, 33.9] | 26.5 [22.7, 32.0] | 31.2 [26.9, 37.0 |
| BMI categories, kg/m2, n (%) | ||||
| <18.5 | 1,533 (1.3) | 1,275 (1.4) | 40 (5.0) | 218 (1.0) |
| 18.5–24.9 | 20,506 (17.6) | 17,136 (18.4) | 274 (34.2) | 3,096 (13.8) |
| 25.0–29.9 | 30,704 (26.4) | 24,500 (26.3) | 209 (26.1) | 5,995 (26.7) |
| 30.0–34.9 | 22,757 (19.6) | 17,168 (18.4) | 132 (16.5) | 5,457 (24.3) |
| 35.0–39.9 | 12,248 (10.5) | 8,810 (9.5) | 69 (8.6) | 3,369 (15.0) |
| ≥40 | 10,913 (9.4) | 7,239 (7.8) | 54 (6.7) | 3,620 (16.1) |
| Unknown | 17,709 (15.2) | 16,970 (18.2) | 24 (3.0) | 715 (3.2) |
| Encounter type, n (%) | ||||
| Emergency | 63,674 (54.7) | 57,040 (61.3) | 193 (24.1) | 6,441 (28.7) |
| Admitted/Inpatient | 40,885 (35.1) | 24,854 (26.7) | 593 (73.9) | 15,438 (68.7) |
| Urgent care encounter | 11,811 (10.1) | 11,204 (12.0) | 16 (2.0) | 591 (2.6) |
| Length of stay (inpatient encounters only), days (median [IQR]) | 4.6 [2.3, 8.7] | 3.8 [2.0, 7.0] | 5.1 [2.6, 10.2] | 6.2 [3.1, 12.2] |
| Length of stay categories (inpatient encounters only), days, n (%) | ||||
| 0–3 | 11,126 (9.6) | 8,048 (8.6) | 146 (18.2) | 2,932 (13.0) |
| 4–7 | 9,103 (7.8) | 5,678 (6.1) | 116 (14.5) | 3,309 (14.7) |
| >7 | 19,795 (17.0) | 10,627 (11.4) | 323 (40.3) | 8,845 (39.4) |
| Not applicable | 75,485 (64.9) | 68,244 (73.3) | 209 (26.1) | 7,032 (31.3) |
| Unknown | 861 (0.7) | 501 (0.5) | 8 (1.0) | 352 (1.6) |
| Intubated, n (%) | 7243 (6.2) | 2571 (2.8) | 113 (14.1) | 4559 (20.3) |
| Intubation duration, days (median [IQR]) | 5.0 [1.0, 11.0] | 3.0 [0.0, 7.0] | 5.0 [2.0, 13.0] | 6.0 [2.0, 14.0] |
| Intubation duration categories, days, n (%) | ||||
| 0–3 | 2929 (2.5) | 1388 (1.5) | 38 (4.7) | 1503 (6.7) |
| 4–7 | 1428 (1.2) | 492 (0.5) | 23 (2.9) | 913 (4.1) |
| 8–14 | 1372 (1.2) | 382 (0.4) | 27 (3.4) | 963 (4.3) |
| >14 | 1238 (1.1) | 182 (0.2) | 18 (2.2) | 1038 (4.6) |
| Not applicable | 109403 (94.0) | 90654 (97.4) | 696 (86.8) | 18053 (80.3) |
| In-hospital mortality, n (%)1 | 2793 (2.4) | 902 (1.0) | 37 (4.6) | 1854 (8.3) |
| Payer, n (%) | ||||
| Private insurance | 44,539 (38.3) | 38,836 (41.7) | 252 (31.4) | 5,451 (24.3) |
| Public insurance | 32,902 (28.3) | 22,111 (23.8) | 292 (36.4) | 10,499 (46.7) |
| Government/Military | 2,580 (2.2) | 2,200 (2.4) | 14 (1.7) | 366 (1.6) |
| Charity/Other | 1,468 (1.3) | 1,212 (1.3) | 9 (1.1) | 247 (1.1) |
| Self-pay | 13,466 (11.6) | 12,480 (13.4) | 44 (5.5) | 942 (4.2) |
| Unknown | 21,415 (18.4) | 16,259 (17.5) | 191 (23.8) | 4,965 (22.1) |
| Census Division, n (%) | ||||
| New England | 1,764 (1.5) | 1,341 (1.4) | 25 (3.1) | 398 (1.8) |
| Middle Atlantic | 21,416 (18.4) | 17,050 (18.3) | 152 (19.0) | 4,214 (18.8) |
| South Atlantic | 38,009 (32.7) | 32,046 (34.4) | 165 (20.6) | 5,798 (25.8) |
| East North Central | 4,869 (4.2) | 3,618 (3.9) | 48 (6.0) | 1,203 (5.4) |
| East South Central | 1,977 (1.7) | 1,646 (1.8) | 19 (2.4) | 312 (1.4) |
| West North Central | 5,036 (4.3) | 3,983 (4.3) | 55 (6.9) | 998 (4.4) |
| West South Central | 12,865 (11.1) | 9,475 (10.2) | 116 (14.5) | 3,274 (14.6) |
| Mountain | 15,136 (13.0) | 11,822 (12.7) | 140 (17.5) | 3,174 (14.1) |
| Pacific | 15,298 (13.1) | 12,117 (13.0) | 82 (10.2) | 3,099 (13.8) |
| Health system: Bed size range, n (%) | ||||
| 6–99 | 1,379 (1.2) | 1,025 (1.1) | 6 (0.7) | 348 (1.5) |
| 100–199 | 806 (0.7) | 661 (0.7) | 1 (0.1) | 144 (0.6) |
| 200–299 | 2,013 (1.7) | 1,615 (1.7) | 16 (2.0) | 382 (1.7) |
| 300–499 | 8,326 (7.2) | 6,364 (6.8) | 74 (9.2) | 1,888 (8.4) |
| 500–999 | 22,714 (19.5) | 17,455 (18.7) | 200 (24.9) | 5,059 (22.5) |
| ≥1,000 | 81,132 (69.7) | 65,978 (70.9) | 505 (63.0) | 14,649 (65.2) |
| Health system: Segment served, n (%) | ||||
| Integrated Delivery Network | 89,176 (76.6) | 71,968 (77.3) | 566 (70.6) | 16,642 (74.1) |
| Regional Hospital | 14,237 (12.2) | 10,721 (11.5) | 115 (14.3) | 3,401 (15.1) |
| Academic | 11,324 (9.7) | 9,133 (9.8) | 106 (13.2) | 2,085 (9.3) |
| Community Hospital | 825 (0.7) | 617 (0.7) | 3 (0.4) | 205 (0.9) |
| Community Healthcare | 361 (0.3) | 251 (0.3) | 2 (0.2) | 108 (0.5) |
| Children | 334 (0.3) | 316 (0.3) | 10 (1.2) | 8 (0.0) |
| Critical Access | 113 (0.1) | 92 (0.1) | 0 (0.0) | 21 (0.1) |
| HbA1c, % (median [IQR]) | 6.7 [5.7, 8.4] | 5.5 [5.2, 5.8] | 9.5 [7.7, 12.0] | 7.5 [6.5, 9.3] |
| HbA1c, mmol/mol (median [IQR]) | 50 [39, 68] | 37 [33, 40] | 80 [61, 108] | 58 [48, 78] |
| Concurrent hyperglycemia and acidosis, n (%) | 2,452 (2.1) | 0 (0.0) | 182 (22.7) | 2,270 (10.1) |
| Vitamin D deficiency/insufficiency, n (%)2 | 3,227 (2.8) | 1,528 (1.6) | 84 (10.5) | 1,615 (7.2) |
| Low vitamin D, lab result not present, n (%)3 | 1,572 (48.7) | 747 (48.9) | 38 (45.2) | 787 (48.7) |
| Serum 25-hydroxyvitamin D result present, n (%)4 | 2,753 (2.4) | 1,347 (1.4) | 55 (6.9) | 1,351 (6.0) |
| Serum 25-hydroxyvitamin D, ng/mL (median [IQR])5 | 27.7 [18.3, 39.1] | 28.8 [19.5, 39.3] | 22.3 [12.9, 28.9] | 27.1 [17.8, 39.2] |
| Serum 25-hydroxyvitamin D <20 ng/mL, n (%) | 842 (0.7) | 375 (0.4) | 25 (3.1) | 442 (2.0) |
| Serum 25-hydroxyvitamin D 20–30 ng/mL, n (%) | 813 (0.7) | 406 (0.4) | 21 (2.6) | 386 (1.7) |
| Elixhauser comorbidity score (median [IQR]) | 0.0 [0.0, 6.0] | 0.0 [0.0, 5.0] | 8.0 [3.0, 19.0] | 10.0 [3.0, 19.0] |
| Elixhauser comorbidity groups, n (median [IQR]) | 1.0 [0.0, 4.0] | 1.0 [0.0, 2.0] | 5.0 [3.0, 8.0] | 6.0 [4.0, 8.0] |
| EC - Congestive heart failure, n (%) | 9,347 (8.0) | 3,209 (3.4) | 168 (20.9) | 5,970 (26.6) |
| EC - Cardiac arrhythmias, n (%) | 20,126 (17.3) | 11,452 (12.3) | 304 (37.9) | 8,370 (37.2) |
| EC - Valvular disease, n (%) | 5,418 (4.7) | 2,387 (2.6) | 83 (10.3) | 2,948 (13.1) |
| EC - Pulmonary circulation disorders, n (%) | 4,230 (3.6) | 1,903 (2.0) | 78 (9.7) | 2,249 (10.0) |
| EC - Peripheral vascular disorders, n (%) | 5,623 (4.8) | 2,075 (2.2) | 95 (11.8) | 3,453 (15.4) |
| EC - Hypertension, n (%) | 44,029 (37.8) | 23,672 (25.4) | 510 (63.6) | 19,847 (88.3) |
| EC - Paralysis, n (%) | 1,714 (1.5) | 684 (0.7) | 25 (3.1) | 1,005 (4.5) |
| EC - Neurodegenerative disorders, n (%) | 5,372 (4.6) | 3,096 (3.3) | 113 (14.1) | 2,163 (9.6) |
| EC - Chronic pulmonary disease, n (%) | 21,765 (18.7) | 14,097 (15.1) | 181 (22.6) | 7,487 (33.3) |
| EC - Hypothyroidism, n (%) | 9,501 (8.2) | 5,375 (5.8) | 151 (18.8) | 3,975 (17.7) |
| EC - Renal failure, n (%) | 10,460 (9.0) | 3,096 (3.3) | 273 (34.0) | 7,091 (31.6) |
| EC - Liver disease, n (%) | 8,221 (7.1) | 4,247 (4.6) | 122 (15.2) | 3,852 (17.1) |
| EC - Peptic ulcer disease (no bleeding), n (%) | 1,269 (1.1) | 583 (0.6) | 25 (3.1) | 661 (2.9) |
| EC - AIDS/HIV, n (%) | 620 (0.5) | 459 (0.5) | 5 (0.6) | 156 (0.7) |
| EC - Lymphoma, n (%) | 482 (0.4) | 278 (0.3) | 9 (1.1) | 195 (0.9) |
| EC - Metastatic cancer, n (%) | 1,060 (0.9) | 561 (0.6) | 9 (1.1) | 490 (2.2) |
| EC - Solid tumor without metastasis, n (%) | 3,915 (3.4) | 2,045 (2.2) | 32 (4.0) | 1,838 (8.2) |
| EC - RA/collagen vascular diseases, n (%) | 2,934 (2.5) | 1,723 (1.9) | 40 (5.0) | 1,171 (5.2) |
| EC - Coagulopathy, n (%) | 7,356 (6.3) | 3,553 (3.8) | 136 (17.0) | 3,667 (16.3) |
| EC - Obesity, n (%) | 23,118 (19.9) | 12,443 (13.4) | 221 (27.6) | 10,454 (46.5) |
| EC - Weight loss, n (%) | 5,490 (4.7) | 2,498 (2.7) | 165 (20.6) | 2,827 (12.6) |
| EC - Fluid and electrolyte disorders, n (%) | 33,550 (28.8) | 18,512 (19.9) | 615 (76.7) | 14,423 (64.2) |
| EC - Blood loss anemia, n (%) | 1,192 (1.0) | 513 (0.6) | 27 (3.4) | 652 (2.9) |
| EC - Deficiency anemia, n (%) | 5,842 (5.0) | 2,714 (2.9) | 152 (19.0) | 2,976 (13.2) |
| EC - Alcohol abuse, n (%) | 375 (0.3) | 243 (0.3) | 8 (1.0) | 124 (0.6) |
| EC - Drug abuse, n (%) | 5,958 (5.1) | 4,239 (4.6) | 145 (18.1) | 1,574 (7.0) |
| EC - Psychosis, n (%) | 2,544 (2.2) | 1,600 (1.7) | 36 (4.5) | 908 (4.0) |
| EC - Depression, n (%) | 13,035 (11.2) | 7,615 (8.2) | 245 (30.5) | 5,175 (23.0) |
1
In-hospital mortality was defined as a discharge disposition of “Expired” in conjunction with the COVID-related encounter.
2
Vitamin D deficiency/insufficiency status was extracted from Cerner’s COVID-19 database via International Classification of Disease, 10th Revision (ICD-10) codes indicating low vitamin D status and/or via laboratory testing indicating low serum 25-hydroxyvitamin D (<30 ng/mL). Codes used to extract vitamin D data are in Supplemental Table 5.
3
Individuals whose low vitamin D status was documented via an ICD-10 code -- but not via laboratory testing -- within 90 days of the index qualifying encounter associated with confirmed SARS-CoV-2 infection.
4
Individuals who had at least one serum 25-hydroxyvitamin D laboratory test result within 90 days of the index qualifying encounter associated with confirmed SARS-CoV-2 infection.
5
Calculated using serum 25-hydroxyvitamin D laboratory testing results for all individuals, regardless of vitamin D deficiency/insufficiency status.
Abbreviations: AIDS/HIV, acquired immunodeficiency syndrome/human immunodeficiency virus; BMI, body mass index; EC, Elixhauser comorbidity; HbA1c, hemoglobin A1c; IQR, interquartile range; LOS, length of stay; RA, rheumatoid arthritis