Glycemic Control and Clinical Outcomes in U.S. Patients With COVID-19: Data From the National COVID Cohort Collaborative (N3C) Database
03 medical and health sciences
Endocrinology
0302 clinical medicine
and Metabolism
Nutritional and Metabolic Diseases
Virus Diseases
Diabetes
Infectious Disease
UMCCTS funding
Endocrine System Diseases
3. Good health
DOI:
10.2337/figshare.19119302.v1
Publication Date:
2022-02-24T18:29:37Z
AUTHORS (15)
ABSTRACT
<i>Objective: </i>The purpose of the study is to
evaluate the relationship between HbA1c and severity of COVID-19 outcomes in
patients with type 2 diabetes mellitus (T2D) with acute COVID-19
infection.
<p><i>Research Design and Methods: </i>We
conducted a retrospective study using observational data from the National
COVID Cohort Collaborative (N3C), a longitudinal, multicenter US cohort of
patients with COVID-19 infection. Patients were ≥18 years old with T2D and
confirmed COVID-19 infection by either laboratory testing or diagnosis code.
The primary outcome was 30-day mortality following the date of COVID-19
diagnosis. Secondary outcomes included need for invasive ventilation or ECMO,
hospitalization within 7 days prior to or 30 days after COVID-19 diagnosis, and
length of stay (LOS) for patients who were hospitalized.</p>
<p><i>Results: </i>The study included 39,616 patients (50.9% female, 55.4% White,
26.4% Black or African American and 16.1% Hispanic or Latino, with mean [SD]
age 62.1 [13.9] years and mean [SD] HbA1c 7.6% [2.0]. There was an increasing
risk of hospitalization with incrementally higher HbA1c levels, but risk of
death plateaued at HbA1c above 8% and risk of invasive ventilation or ECMO
plateaued above 9%. There was no significant difference in LOS across HbA1c
levels. </p>
<p><i>Conclusions: </i>In a large, multicenter cohort of
patients in the US with T2D and COVID-19 infection, risk of hospitalization
increased with incrementally higher HbA1c levels. Risk of death and invasive
ventilation also increased but plateaued at different levels of glycemic
control.</p>
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