Risk and COVID-19 related mortality in England for diabetes population

Professor Kamlesh Khunti, co-Director of the Leicester Diabetes Centre, was a key part of a national team that for the first time has investigated risk and COVID-19 related mortality in England for diabetes population. The full publication can be accessed below.

Background

Although diabetes has been associated with COVID-19 mortality, the absolute and relative risks for Type 1 and Type 2 diabetes are unknown.

Methods

A population cohort study assessing risks of in-hospital death with COVID-19 between 1st March and 11th May 2020, including individuals registered with a General Practice in England and alive on February 19th 2020. Multivariate logistic regression examined diabetes status, by type, and associations with in-hospital death, adjusting for demographic factors and comorbidities.

Findings

Of the 61,414,470 individuals registered, 263,830 (0∙4%) had a recorded diagnosis of Type 1 and 2,864,670 (4∙7%) of Type 2 diabetes. There were 23,804 COVID-19 related deaths. One third occurred in people with diabetes: 7,466 (31∙4%) with Type 2 and 365 (1∙5%) with Type 1 diabetes. Crude mortality rates per 100,000 persons over the 72 days for the overall population and for those with Type 1 and Type 2 diabetes were 38∙8 (38∙3-39∙3), 138∙3 (124∙5-153∙3), and 260∙6 (254∙7-266∙6) respectively. Adjusted for age, sex, deprivation, ethnicity and geographical region, people with Type 1 and Type 2 diabetes had 3∙50 (3∙15-3∙89) and 2∙03 (1∙97- 2∙09) times the odds respectively of dying in hospital with COVID-19 compared to those without diabetes, attenuated to 2∙86 and 1∙81 respectively when also adjusted for previous hospital admissions with coronary heart disease, cerebrovascular disease or heart failure.

Interpretation

This nationwide analysis in England demonstrates that all types of diabetes are independently associated with a significant increased risk of in-hospital death with COVID-19.

Funding

NHS England & Improvement and Public Health England.

The full publication can be accessed here: https://www.england.nhs.uk/publication/type-1-and-type-2-diabetes-and-covid-19-related-mortality-in-england/