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
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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