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Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity

Marc Diedisheim 1, 2 Etienne Dancoisne 3 Jean-François Gautier 1, 4 Etienne Larger 2 Emmanuel Cosson 5, 6 Bruno Fève 7, 8, 9 Philippe Chanson 10, 11 Sébastien Czernichow 12, 13 Sopio Tatulashvili 14, 15 Marie-Laure Raffin-Sanson 16, 17 Muriel Bourgeon 18 Christiane Ajzenberg 19 Agnès Hartemann 8, 20 Christel Daniel 21 Thomas Moreau 22, 23 Ronan Roussel 24, 1 Louis Potier 24, 1 
14 CRESS - U1153 - Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle
Université Sorbonne Paris Nord, CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
22 PARIETAL - Modelling brain structure, function and variability based on high-field MRI data
NEUROSPIN - Service NEUROSPIN, Inria Saclay - Ile de France
Abstract : Context: Diabetes is reported as a risk factor for severe COVID-19, but whether this risk is similar in all categories of age remains unclear. Objective: To investigate the risk of severe COVID-19 outcomes in hospitalized patients with and without diabetes according to age categories. Design setting and participants: We conducted a retrospective observational cohort study of 6,314 consecutive patients hospitalized for COVID-19 between February and June 30 2020, and follow-up recorded until 30 September 2020, in the Paris metropolitan area, France. Main outcome measure(s): The main outcome was a composite outcome of mortality and orotracheal intubation in subjects with diabetes compared with subjects without diabetes, after adjustment for confounding variables and according to age categories. Results: Diabetes was recorded in 39% of subjects. Main outcome was higher in patients with diabetes, independently of confounding variables (HR 1.13 [1.03-1.24]) and increased with age in individuals without diabetes, from 23% for those <50 to 35% for those >80 years but reached a plateau after 70 in those with diabetes. In direct comparison between patients with and without diabetes, diabetes-associated risk was inversely proportional to age, highest in <50 and similar after 70 years. Similarly, mortality was higher in patients with diabetes (26%) than in those without diabetes (22%, p<0.001), but adjusted HR for diabetes was significant only in patients under 50 (HR 1.81 [1.14-2.87]). Conclusions: Diabetes should be considered as an independent risk factor for the severity of COVID-19 in young adults more so than in older adults, especially for individuals younger than 70 years.
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Submitted on : Wednesday, June 2, 2021 - 4:01:22 PM
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Marc Diedisheim, Etienne Dancoisne, Jean-François Gautier, Etienne Larger, Emmanuel Cosson, et al.. Diabetes increases severe COVID-19 outcomes primarily in younger adults Age and diabetes in COVID-19 severity. Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2021, ⟨10.1210/clinem/dgab393⟩. ⟨hal-03246831⟩



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