Title

Glycemic Control and Clinical Outcomes in U.S. Patients With COVID-19: Data From the National COVID Cohort Collaborative (N3C) Database

UMMS Affiliation

UMass Center for Clinical and Translational Science

Publication Date

2022-02-24

Document Type

Article

Disciplines

Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Infectious Disease | Nutritional and Metabolic Diseases | Virus Diseases

Abstract

OBJECTIVE: The purpose of the study is to evaluate the relationship between HbA1c and severity of coronavirus disease 2019 (COVID-19) outcomes in patients with type 2 diabetes (T2D) with acute COVID-19 infection.

RESEARCH DESIGN AND METHODS: We conducted a retrospective study using observational data from the National COVID Cohort Collaborative (N3C), a longitudinal, multicenter U.S. cohort of patients with COVID-19 infection. Patients were > /=18 years old with T2D and confirmed COVID-19 infection by 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 extracorporeal membrane oxygenation (ECMO), hospitalization within 7 days before or 30 days after COVID-19 diagnosis, and length of stay (LOS) for patients who were hospitalized.

RESULTS: 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 > 8%, and risk of invasive ventilation or ECMO plateaued >9%. There was no significant difference in LOS across HbA1c levels.

CONCLUSIONS: In a large, multicenter cohort of patients in the U.S. 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.

Keywords

UMCCTS funding

DOI of Published Version

10.2337/dc21-2186

Source

Wong R, Hall M, Vaddavalli R, Anand A, Arora N, Bramante CT, Garcia V, Johnson S, Saltz M, Tronieri JS, Yoo YJ, Buse JB, Saltz J, Miller J, Moffitt R. Glycemic Control and Clinical Outcomes in U.S. Patients With COVID-19: Data From the National COVID Cohort Collaborative (N3C) Database. Diabetes Care. 2022 Feb 24:dc212186. doi: 10.2337/dc21-2186. Epub ahead of print. PMID: 35202458. Link to article on publisher's site

Journal/Book/Conference Title

Diabetes care

Comments

The UMass Center for Clinical and Translational Science (UMCCTS), UL1TR001453, helped fund this study.

Related Resources

Link to Article in PubMed

PubMed ID

35202458

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