Abstract: Diabetes Ther (2021) 12:2223–2239 https://doi.org/10.1007/s13300-021-01110-1 ORIGINAL RESEARCH Risk Factors Associated with COVID-19 Hospitalization and Mortality: A Large Claims-Based Analysis Among People with Type 2 Diabetes Mellitus in the United States Kristina S. Boye . Elif Tokar Erdemir . Nathan Zimmerman . Abraham Reddy . Brian D. Benneyworth . Matan C. Dabora . Emily R. Hankosky . M. Angelyn Bethel . Callahan Clark . Cody J. Lensing . Scott Sailer . Ramira San Juan . Robert J. Heine . Lida Etemad Received: April 28, 2021 / Accepted: June 28, 2021 / Published online: July 18, 2021 Ó The Author(s) 2021 ABSTRACT Introduction: Diabetes has been identified as a high-risk comorbidity for COVID-19 hospitalization. We evaluated additional risk factors for COVID-19 hospitalization and in-hospital mortality in a nationwide US database. Methods: This retrospective study utilized the UnitedHealth Group Clinical Discovery Database (January 1, 2019–July 15, 2020) containing de-identified nationwide administrative claims, SARS-CoV-2 laboratory test results, and COVID19 inpatient admissions data. Logistic regression was used to understand risk factors for hospitalization and in-hospital mortality among people with type 2 diabetes (T2D) and in the overall population. Robustness of associations was further confirmed by subgroup and sensitivity analyses in the T2D population. Supplementary Information The online version contains supplementary material available at https:// doi.org/10.1007/s13300-021-01110-1. K. S. Boye
B. D. Benneyworth
M. C. Dabora
E. R. Hankosky
M. A. Bethel
R. J. Heine Eli Lilly and Company, Indianapolis, IN, USA E. Tokar Erdemir (&)
N. Zimmerman
A. Reddy
C. Clark
C. J. Lensing
S. Sailer
R. San Juan
L. Etemad OptumLabs at UnitedHealth Group, Minneapolis, MN, USA e-mail: eliftokar@gmail.com Results: A total of 36,364 people were identified who were either SARS-CoV-2? or hospitalized for COVID-19. T2D was associated with increased COVID-19-related hospitalization and mortality. Factors associated with increased hospitalization risk were largely consistent in the overall population and the T2D subgroup, including age, male sex, and these top five comorbidities: dementia, metastatic tumor, congestive heart failure, paraplegia, and metabolic disease. Biguanides (mainly metformin) were consistently associated with lower odds of hospitalization, whereas sulfonylureas and insulins were associated with greater odds of hospitalization among people with T2D. Conclusion: In this nationwide US analysis, T2D was identified as an independent risk factor for COVID-19 complications. Many factors conferred similar risk of hospitalization across both populations; however, particular diabetes medications may be markers for differential risk. The insights on comorbidities and medications may inform population health initiatives, including prevention efforts for high-risk patient populations such as those with T2D. Keywords: Claim-based analysis; COVID-19; Risk factors; SARS-CoV-2; Type 2 diabetes 2224 Key Summary Points Why carry out this study? The clinical and demographic characteristics as well as specific risk factors of patients with diabetes with severe forms of COVID-19 in the US have not been extensively studied. This study aimed to characterize additional risk factors for COVID-19 hospitalization and in-hospital mortality among those with type 2 diabetes mellitus (T2DM) and the overall population in..