Endocrinol Metab.  2020 Dec;35(4):901-908. 10.3803/EnM.2020.787.

Clinical Outcomes of COVID-19 Patients with Type 2 Diabetes: A Population-Based Study in Korea

Affiliations
  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
  • 2Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
  • 3Research Institute of National Health Insurance Service Ilsan Hospital, Goyang, Korea
  • 4Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
  • 5Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 6Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
  • 7Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
  • 8Department of Medicine, University of Washington, Seattle, WA, USA

Abstract

Background
The aim of this study was to evaluate clinical outcomes in coronavirus disease 2019 (COVID-19) positive patients with type 2 diabetes compared to those without diabetes in Korea.
Methods
We extracted claims data for patients diagnosed with COVID-19 from the National Health Insurance Service database in Korea from January 20, 2020 to March 31, 2020. We followed up this cohort until death from COVID-19 or discharge from hospital.
Results
A total of 5,473 patients diagnosed with COVID-19 were analyzed, including 495 with type 2 diabetes and 4,978 without diabetes. Patients with type 2 diabetes were more likely to be treated in the intensive care unit (ICU) (P<0.0001). The incidence of inhospital mortality was higher in patients with type 2 diabetes (P<0.0001). After adjustment for age, sex, insurance status, and comorbidities, odds of ICU admission (adjusted odds ratio [OR], 1.59; 95% confidence interval [CI], 1.02 to 2.49; P=0.0416) and in-hospital mortality (adjusted OR, 1.90; 95% CI, 1.13 to 3.21; P=0.0161) among patients with COVID-19 infection were significantly higher in those with type 2 diabetes. However, there was no significant difference between patients with and without type 2 diabetes in ventilator, oxygen therapy, antibiotics, antiviral drugs, antipyretics, and the incidence of pneumonia after adjustment.
Conclusion
COVID-19 positive patients with type 2 diabetes had poorer clinical outcomes with higher risk of ICU admission and in-hospital mortality than those without diabetes. Therefore, medical providers need to consider this more serious clinical course when planning and delivering care to type 2 diabetes patients with COVID-19 infection.

Keyword

COVID-19; Diabetes mellitus; type 2; Incidence; Mortality; Epidemiology

Cited by  1 articles

Risk for Newly Diagnosed Type 2 Diabetes Mellitus after COVID-19 among Korean Adults: A Nationwide Matched Cohort Study
Jong Han Choi, Kyoung Min Kim, Keeho Song, Gi Hyeon Seo
Endocrinol Metab. 2023;38(2):245-252.    doi: 10.3803/EnM.2023.1662.


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