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IDF2022-0622 Mortality and cardiorenal disease in type 1 and type 2 diabetes after COVID-19 and influenza hospitalization in Sweden

https://doi.org/10.1016/j.diabres.2023.110543Get rights and content

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Background

The risk of severe COVID-19 is increased in diabetes patients, but effects of diabetes type and other risk factors are incompletely characterized.

Aim

To study effects of diabetes type and other risk factors on mortality and incident cardiorenal events in a Swedish cohort of diabetes patients hospitalized due to COVID-19, also including comparisons with influenza epidemics of previous years.

Method

Patients >18 years of age were identified in national healthcare registries. 31,442 diabetes patients (T1D, n = 1,427; T2D, n = 30,015) were admitted with COVID-19 from January 1, 2020 to September 9, 2021. 5,111 diabetes patients (304 T1D, 4,807 T2D) were admitted with influenza from January 1, 2015 to December 31, 2019. Main outcomes were death and new hospitalizations due to heart failure (HF), chronic kidney disease (CKD) and cardiorenal disease (CRD, HF and/or CKD) during 1 year of

Results

There were 3,669 deaths (11.7%) in COVID-19 and 259 deaths (5.1%) in influenza. In COVID-19, CRD event rate was 11.8/100 person-years for T1D and 15.1 for T2D (in influenza, 12.3 for T1D and 12.7 for T2D). Presented in Figure 1, age- and sex-adjusted regression models showed increased risks of death and CKD following COVID-19 in T1D vs T2D, hazard ratio (HR) 1.27 and 1.53. In influenza, T1D was associated with increased risk of death, HR 1.80. Higher age and previous CRD were associated with

Conclusion

Diabetes patients have an elevated risk of death and cardiorenal complications up to 1 year after COVID-19 hospitalization. T1D patients are more vulnerable than T2D patients regarding death and renal impairment after hospitalization due to COVID-19 and influenza. In both T1D and T2D, hospitalization due to COVID-19 compared to influenza confers greater mortality. Previous CRD is an important risk factor for detrimental outcomes following COVID-19.

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