Letter to the Editor
In 2020 the whole world has been challenged by the SARS-CoV-2 virus
(Coronavirus-19) (1). Following coronavirus-19 infection people with
diabetes are at higher risk than those who do not have diabetes, of
becoming very unwell and in some cases dying (2,3,4). Notably Barron et
al (4) reported an odds ratio (OR) of 2.03 (95% CI 1.97-2.09) for
in-hospital coronavirus-19 related death in people with type 2 diabetes
(T2DM). A body of work is emerging which is beginning to explain why
people with diabetes are more likely to become seriously unwell
following a coronavirus-19 infection. However much of the detail remains
to be determined (3).
For people with diabetes 2020 has been a very difficult year, with the
awareness that their condition puts them at an increased risk of
becoming very seriously unwell/dying following coronavirus-19 infection.
It is therefore critical to determine all the factors that put any
person with diabetes at an increased risk of a serious outcome after
contracting a coronavirus-19 infection.
In one area of the UK (Salford) over the period of March-October 2020,
we examined the potential risk factors relating to mortality in people
with T2DM, who were confirmed as being coronavirus-19 positive. We
examined health records for a representative sample of 308 T2DM people
who were confirmed to be infected with the coronavirus-19. Of these 56
people died, with the peak mortality rates seen in the months of
April/May 2020.
Overall deaths for T2DM individuals living in Salford were 100% higher
in March, 220% higher in April and 34% higher in May 2020 compared
with the previous 5 year average monthly mortality rates for people with
T2DM. Those who died following a confirmed coronavirus-19 infection were
significantly older than those who survived (age±95% confidence
Interval (CI)) at 82.8±10.3 vs 70.7±14.8 years (p<0.001). In
logistic regression analysis, only age (Odds ratio (OR) (95% CI)) 1.07
(1.02-1.12) was predictive of death following coronavirus-19 infection,
independent of gender, glycosylated haemoglobin (HbA1c), diastolic blood
pressure, body mass index, serum creatinine, serum cholesterol, smoking
status, and urine albumin/creatinine ratio. We were not able to include
ethnicity in the analysis, as the sample included only a small number of
people of non-Caucasian ethnic origin
This analysis highlights the fact that age outweighs many other factors
in people with T2DM in relation to mortality from the coronavirus-19
once infected. This fact should be taken into account in relation to the
vaccination programme against the coronavirus-19 in people with T2DM in
the UK and elsewhere, while emphasising as always, support for
concordance with lifestyle and pharmacological management in order to
optimise the health of the individual.