Impact of overlapping risks of type 2 diabetes and obesity on coronavirus disease severity in the United States

Sci Rep. 2021 Sep 9;11(1):17968. doi: 10.1038/s41598-021-96720-x.

Abstract

The impact of overlapping risk factors on coronavirus disease (COVID-19) severity is unclear. To evaluate the impact of type 2 diabetes (T2D) and obesity on COVID-19 severity, we conducted a cohort study with 28,095 anonymized COVID-19 patients using data from the COVID-19 Research Database from January 1, 2020 to November 30, 2020. The mean age was 50.8 ± 17.5 years, and 11,802 (42%) patients were male. Data on age, race, sex, T2D complications, antidiabetic medication prescription, and body mass index ≥ 30 kg/m2 (obesity) were analysed using Cox proportional hazard models, with hospitalization risk and critical care within 30 days of COVID-19 diagnosis as the main outcomes. The risk scores were 0-4 for age ≥ 65 years, male sex, T2D, and obesity. Among the participants, 11,294 (61.9%) had obesity, and 4445 (15.8%) had T2D. T2D, obesity, and male sex were significantly associated with COVID-19 hospitalization risk. Regarding hospitalization risk scores, compared with those for hospitalization risk score 0 and critical care risk score 0, hazard ratios [95% confidence intervals] were 19.034 [10.470-34.600] and 55.803 [12.761-244.015] (P < 0.001) (P < 0.001), respectively, for risk score 4. Complications from diabetes and obesity increased hospitalization and critical care risks for COVID-19 patients.

MeSH terms

  • Aged
  • Aging / pathology
  • COVID-19 / pathology*
  • COVID-19 Drug Treatment
  • Critical Care / statistics & numerical data*
  • Diabetes Complications / pathology
  • Diabetes Mellitus, Type 2 / pathology*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Intensive Care Units / statistics & numerical data
  • Male
  • Metformin / therapeutic use
  • Middle Aged
  • Obesity / pathology*
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index*
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • United States

Substances

  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Metformin