Type 2 Diabetes Status, Diabetes Complication Severity Index Scores, and Their Relationship With COVID-19 Severity: A Retrospective Cohort Study of Hospitalized Patients in a Southwest Virginia Health System.

Publication date: Feb 01, 2024

Background Studies have shown that patients with type 2 diabetes mellitus (T2DM) tend to have poorer outcomes associated with COVID-19, including increased rates of hospitalization, ICU admission, need for ventilatory support, and mortality. Methods We performed a retrospective cohort study that included all non-pregnant adult patients who were hospitalized as a result of COVID-19 in a Southwest Virginia health system between March 18, 2020, and August 31, 2022. T2DM status was treated as a binary variable. T2DM severity was assessed using the Diabetes Complications Severity Index (DCSI). Multivariate logistic regression was used to assess the relationship between T2DM status and COVID-19 severity outcomes. Multivariate logistic regression was also used to assess the relationship between DCSI score and COVID-19 severity outcomes among patients with an established diagnosis of T2DM at the time of COVID-19 hospital admission. Results Patients with T2DM had 1. 27 times the odds of experiencing a poor COVID-19 clinical outcome (95% CI: 1. 13, 1. 43) and 1. 35 times the odds of in-hospital mortality (95% CI: 1. 14, 1. 59) compared to patients without diabetes. Among patients with T2DM, increasing DCSI score was significantly associated with increased odds of experiencing a poor COVID-19 clinical outcome and in-hospital mortality. Conclusions Diabetic patients in our sample were at increased odds of experiencing poor COVID-19 clinical outcomes and in-hospital mortality compared to individuals without diabetes. Amongst patients with T2DM, increasing DCSI score was associated with worse COVID-19 outcomes. Clinical decision support tools may be able to utilize DCSI scores as an indicator of COVID-19 severity risk to facilitate decisions regarding treatment aggressiveness and resource allocation.

Concepts Keywords
Diabetes covid-19
Poorer in-hospital outcomes
Pregnant retrospective cohort study
Ventilatory type 2 diabetes


Type Source Name
disease MESH Type 2 Diabetes
disease MESH Diabetes Complication
disease MESH COVID-19
disease VO time

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