COVID-19 Hospitalization in Adults with Type 1 Diabetes: Results from the T1D Exchange Multicenter Surveillance Study
COVID-19 Hospitalization in Adults with Type 1 Diabetes: Results from the T1D Exchange Multicenter Surveillance Study
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DOI：
10.1210/clinem/dgaa825
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发表时间：
2021-01-23
影响因子：
5.8
通讯作者：
Levy, Carol J.
中科院分区：
文献类型：
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作者：
O'Malley, Grenye;Ebekozien, Osagie;Levy, Carol J.
糖尿病与COVID-19发病率和死亡率增加有关，但很少有数据关注1型糖尿病患者的结局。目的本研究的目的是分析成人1型糖尿病患者的特征与COVID-19住院的相关性。设计：进行了一项观察性多中心横断面研究。糖尿病护理提供者回答了一份关于人口统计学、症状以及糖尿病和COVID-19相关护理和结局的33项问卷。采用描述性统计量描述研究人群，采用多变量logistic回归模型分析糖化血红蛋白（HbA 1c）、年龄、合并症和住院之间的关系。2020年3月至8月期间，52家美国研究中心提交了设定病例。患者或其他参与者包括19岁以上患有1型糖尿病并确诊COVID-19感染的成年人。无干预。主要指标COVID-19感染住院情况。结果共分析113例。住院治疗58例，死亡5例。住院的患者更有可能是老年人，确定为非西班牙裔黑人，使用公共保险或患有高血压，并且不太可能使用动态血糖监测或胰岛素泵。中位HbA 1c为8.6%（70 mmol/mol），与住院呈正相关（比值比1.42，95%置信区间1.18-1.76），在校正年龄、性别、种族和肥胖后仍持续存在。结论基线血糖控制和获得护理是重要的可改变的风险因素，需要加以解决，以优化全球COVID-19大流行期间1型糖尿病患者的护理。
Context Diabetes mellitus is associated with increased COVID-19 morbidity and mortality, but there are few data focusing on outcomes in people with type 1 diabetes. Objective The objective of this study was to analyze characteristics of adults with type 1 diabetes for associations with COVID-19 hospitalization. Design An observational multisite cross-sectional study was performed. Diabetes care providers answered a 33-item questionnaire regarding demographics, symptoms, and diabetes- and COVID-19-related care and outcomes. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between glycated hemoglobin (HbA1c), age, and comorbidities and hospitalization. Setting Cases were submitted from 52 US sites between March and August 2020. Patients or Other Participants Adults over the age of 19 with type 1 diabetes and confirmed COVID-19 infection were included. Interventions None. Main Outcome Measures Hospitalization for COVID-19 infection. Results A total of 113 cases were analyzed. Fifty-eight patients were hospitalized, and 5 patients died. Patients who were hospitalized were more likely to be older, to identify as non-Hispanic Black, to use public insurance, or to have hypertension, and less likely to use continuous glucose monitoring or insulin pumps. Median HbA1c was 8.6% (70 mmol/mol) and was positively associated with hospitalization (odds ratio 1.42, 95% confidence interval 1.18-1.76), which persisted after adjustment for age, sex, race, and obesity. Conclusions Baseline glycemic control and access to care are important modifiable risk factors which need to be addressed to optimize care of people with type 1 diabetes during the worldwide COVID-19 pandemic.