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T2DM in Middle Age Ups Mortality Risk in COVID-19 Infection

FRIDAY, Feb. 19, 2021 -- Mortality risk from infection with COVID-19 among middle-aged adults with type 2 diabetes is elevated compared with adults without diabetes and is the equivalent of adding 20 years of chronological age to assessing overall related death risk, according to a research letter published online Feb. 16 in Diabetologia.

Andrew P. McGovern, from the University of Exeter Medical School in the United Kingdom, and colleagues used data from the COVID-19 Hospitalisation in England Surveillance System cohort (19,256 individuals admitted to critical care in England; 18.3 percent with type 2 diabetes). Hazard ratio estimates were translated into "COVID-age," which represents the additional years of COVID-19 mortality risk added to an individual's chronological age if diabetes is present.

The researchers report that overall, the 30-day in-hospital mortality rate was 26.4 percent. The additional COVID-19 mortality risk associated with diabetes (COVID-age) was markedly higher in younger than older people, reflecting the higher relative risk of COVID-19-related mortality associated with diabetes in younger age groups (hazard ratios for diabetes, >5 in adults <50 years of age). The additional mortality risk was equivalent to around 20 years of chronological age for a person aged 40 years with diabetes, yielding an overall mortality risk similar to that of a 60-year-old person without diabetes. The impact of COVID-age shrinks for older adults, with a person aged 70 years with diabetes having an additional eight years of mortality risk from diabetes, yielding a COVID-age of 78 years.

"Strategies to define priority groups for vaccination must consider the disproportionate relative risk of COVID-19 mortality in middle-aged people with type 2 diabetes whose COVID-19 risk is already elevated by their age," McGovern said in a statement. "We recommend that anyone with diabetes takes up the vaccine as soon as it's available to them."

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