Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity - Sorbonne Université Access content directly
Journal Articles Journal of Clinical Endocrinology and Metabolism Year : 2021

Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity

1 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
2 Service de diabétologie [CHU Cochin]
3 CIC - CHU Bichat
4 Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
5 CRNH-IDF - Centre de Recherche en Nutrition Humaine d'Ile-de-France
6 UREN - Unité de Recherche en Epidémiologie Nutritionnelle
7 CHU Saint-Antoine [AP-HP]
8 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
9 CRSA - Centre de Recherche Saint-Antoine
10 PHYSENDO - Physiologie et physiopathologie endocriniennes
11 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
12 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques
13 HEGP - Hôpital Européen Georges Pompidou [APHP]
14 EREN [CRESS - U1153 / UMR_A 1125] - Nutritional Epidemiology Research Team | Equipe de Recherche en Epidémiologie Nutritionnelle
15 Hôpital Avicenne [AP-HP]
16 Service d’endocrinologie et nutrition [AP-HP Ambroise-Paré]
17 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil
18 AP-HP - Hôpital Antoine Béclère [Clamart]
19 CHU Henri Mondor [Créteil]
20 CHU Pitié-Salpêtrière [AP-HP]
21 LIMICS - Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé
22 PARIETAL - Modelling brain structure, function and variability based on high-field MRI data
23 CEA - CEA- Saclay
24 Service d'endocrinologie, diabétologie et nutrition [CHU Bichat]
Etienne Larger

Abstract

Context: Diabetes is reported as a risk factor for severe COVID-19, but whether this risk is similar in all categories of age remains unclear. Objective: To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories. Design setting and participants: We conducted a retrospective observational cohort study of 6,314 consecutive patients hospitalized for COVID-19 between February and June 30 2020, and follow-up recorded until 30 September 2020, in the Paris metropolitan area, France. Main outcome measure(s): The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories. Results: Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (HR 1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, p<0.001), but adjusted HR for diabetes was significant only in patients under 50 (HR 1.81 [1.14-2.87]). Conclusions: Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
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Dates and versions

hal-03246831 , version 1 (02-06-2021)

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Marc Diedisheim, Etienne Dancoisne, Jean-François Gautier, Etienne Larger, Emmanuel Cosson, et al.. Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity. Journal of Clinical Endocrinology and Metabolism, 2021, 106 (9), pp.E3364-E3368. ⟨10.1210/clinem/dgab393⟩. ⟨hal-03246831⟩
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