Impact of overlapping risks of type 2 diabetes and obesity on coronavirus disease severity in the United States

DOI record: { "DOI": "10.1038/s41598-021-96720-x", "ISSN": [ "2045-2322" ], "URL": "http://dx.doi.org/10.1038/s41598-021-96720-x", "abstract": "<jats:title>Abstract</jats:title><jats:p>The impact of overlapping risk factors on coronavirus disease (COVID-19) severity is unclear. To evaluate the impact of type 2 diabetes (T2D) and obesity on COVID-19 severity, we conducted a cohort study with 28,095 anonymized COVID-19 patients using data from the COVID-19 Research Database from January 1, 2020 to November 30, 2020. The mean age was 50.8 ± 17.5 years, and 11,802 (42%) patients were male. Data on age, race, sex, T2D complications, antidiabetic medication prescription, and body mass index ≥ 30 kg/m<jats:sup>2</jats:sup> (obesity) were analysed using Cox proportional hazard models, with hospitalization risk and critical care within 30 days of COVID-19 diagnosis as the main outcomes. The risk scores were 0–4 for age ≥ 65 years, male sex, T2D, and obesity. Among the participants, 11,294 (61.9%) had obesity, and 4445 (15.8%) had T2D. T2D, obesity, and male sex were significantly associated with COVID-19 hospitalization risk. Regarding hospitalization risk scores, compared with those for hospitalization risk score 0 and critical care risk score 0, hazard ratios [95% confidence intervals] were 19.034 [10.470–34.600] and 55.803 [12.761–244.015] (<jats:italic>P</jats:italic> &lt; 0.001) (<jats:italic>P</jats:italic> &lt; 0.001), respectively, for risk score 4. Complications from diabetes and obesity increased hospitalization and critical care risks for COVID-19 patients.</jats:p>", "alternative-id": [ "96720" ], "article-number": "17968", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "9 February 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "12 August 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "9 September 2021" }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 1, "value": "The authors declare no competing interests." } ], "author": [ { "affiliation": [], "family": "Ando", "given": "Wataru", "sequence": "first" }, { "affiliation": [], "family": "Horii", "given": "Takeshi", "sequence": "additional" }, { "affiliation": [], "family": "Uematsu", "given": "Takayuki", "sequence": "additional" }, { "affiliation": [], "family": "Hanaki", "given": "Hideaki", "sequence": "additional" }, { "affiliation": [], "family": "Atsuda", "given": "Koichiro", "sequence": "additional" }, { "affiliation": [], "family": "Otori", "given": "Katsuya", "sequence": "additional" } ], "container-title": [ "Scientific Reports" ], "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2021, 9, 9 ] ], "date-time": "2021-09-09T10:06:24Z", "timestamp": 1631181984000 }, "deposited": { "date-parts": [ [ 2021, 9, 9 ] ], "date-time": "2021-09-09T10:35:13Z", "timestamp": 1631183713000 }, "indexed": { "date-parts": [ [ 2021, 12, 11 ] ], "date-time": "2021-12-11T23:26:47Z", "timestamp": 1639265207258 }, "is-referenced-by-count": 1, "issn-type": [ { "type": "electronic", "value": "2045-2322" } ], "issue": "1", "issued": { "date-parts": [ [ 2021, 9, 9 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2021, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 9, 9 ] ], "date-time": "2021-09-09T00:00:00Z", "timestamp": 1631145600000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 9, 9 ] ], "date-time": "2021-09-09T00:00:00Z", "timestamp": 1631145600000 } } ], "link": [ { "URL": "https://www.nature.com/articles/s41598-021-96720-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.nature.com/articles/s41598-021-96720-x", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.nature.com/articles/s41598-021-96720-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1038", "published": { "date-parts": [ [ 2021, 9, 9 ] ] }, "published-online": { "date-parts": [ [ 2021, 9, 9 ] ] }, "published-print": { "date-parts": [ [ 2021, 12 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1038/s41586-020-2918-0", "author": "M O'Driscoll", "doi-asserted-by": "publisher", "first-page": "140", "journal-title": "Nature", "key": "96720_CR1", "unstructured": "O’Driscoll, M. et al. 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