Risk factors for COVID-19 case fatality rate in people with type 1 and type 2 diabetes mellitus: A nationwide retrospective cohort study of 235,248 patients in the Russian Federation

{ 'indexed': {'date-parts': [[2022, 8, 9]], 'date-time': '2022-08-09T08:42:40Z', 'timestamp': 1660034560412}, 'reference-count': 49, 'publisher': 'Frontiers Media SA', 'license': [ { 'start': { 'date-parts': [[2022, 8, 9]], 'date-time': '2022-08-09T00:00:00Z', 'timestamp': 1660003200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/501100012190', 'name': 'Ministry of Science and Higher Education of the Russian Federation', 'doi-asserted-by': 'publisher'}], 'content-domain': {'domain': ['frontiersin.org'], 'crossmark-restriction': True}, 'abstract': '<jats:sec><jats:title>The aim</jats:title><jats:p>To study the association of demographic, ' 'clinical, and laboratory factors and the use of glucose-lowering drugs and anti-coronavirus ' 'disease (COVID-19) vaccination with the COVID-19-related case fatality rate (CFR) in diabetes ' 'mellitus (DM) ' 'patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study is ' 'a nationwide observational cohort study based on the data from the National Diabetes Register ' '(NDR) that is the database containing online clinical information about the population with ' 'DM. The outcomes (death or recovery) for COVID-19 were registered in 235,248 patients with DM ' '[type 1 diabetes mellitus (T1DM), n = 11,058; type 2 diabetes mellitus (T2DM), n = 224,190] ' 'from March 20, 2020, until November 25, 2021. The unadjusted odds ratio (OR) and 95% ' 'confidence interval (CI) were used to estimate the risk factors for CFR. Then the ranging of ' 'significant factors was performed and the most vulnerable groups of factors for the lethal ' 'outcome were chosen.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The ' 'CFR due to COVID-19 was 8.1% in T1DM and 15.3% in T2DM. Increased CFR was associated with the ' 'male population [OR = 1.25 (95% CI: 1.09–1.44) in T1DM and 1.18 (95% CI: 1.15–1.21) in T2DM], ' 'age ≥65 years [OR = 4.44 (95% CI: 3.75–5.24) in T1DM and 3.18 (95% CI: 3.09–3.26) in T2DM], ' 'DM duration ≥10 years [OR = 2.46 (95% CI: 2.06–2.95) in T1DM and 2.11 (95% CI: 2.06–2.16) in ' 'T2DM], body mass index (BMI) ≥30 kg/m<jats:sup>2</jats:sup> [OR = 1.95 (95% CI: 1.52–2.50)] ' 'in T1DM, HbA1c ≥7% [OR = 1.35 (95% CI: 1.29–1.43)] in T2DM. The atherosclerotic ' 'cardiovascular disease (ASCVD) and chronic kidney disease (CKD) were associated with higher ' 'CFR in T1DM but not in T2DM. The pre-COVID-19 glucose-lowering therapy in T2DM was ' 'differently associated with CFR (OR): 0.61 (95% CI: 0.59–0.62) for metformin, 0.59 (95% CI: ' '0.57–0.61) for dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), 0.46 (95% CI: 0.44–0.49) ' 'for sodium-glucose co-transporter-2 (SGLT2) inhibitors, 0.38 (95% CI: 0.29–0.51) for ' 'glucagon-like peptide-1 receptor agonists (arGLP-1), 1.34 (95% CI: 1.31–1.37) for ' 'sulfonylurea (SU), and 1.47 (95% CI: 1.43–1.51) for insulin. Anti-COVID-19 vaccination was ' 'associated with a lower fatality risk in both DM types: OR = 0.07 (95% CI: 0.03–0.20) in T1DM ' 'and OR = 0.19 (95% CI: 0.17–0.22) in ' 'T2DM.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The results of ' 'our study suggest that increased COVID-19-related fatality risk in both T1DM and T2DM ' 'patients associated with the male population, older age, longer DM duration, and absence of ' 'anti-COVID-19 vaccination. In T2DM, pre-COVID-19 glucose-lowering therapy with metformin, ' 'DPP-4 inhibitors, SGLT2 inhibitors, and arGLP-1 had a positive effect on the risk of death. ' 'The most vulnerable combination of risk factors for lethal outcome in both DM types was ' 'vaccine absence + age ≥65 years + DM duration ≥10 years.</jats:p></jats:sec>', 'DOI': '10.3389/fendo.2022.909874', 'type': 'journal-article', 'created': {'date-parts': [[2022, 8, 9]], 'date-time': '2022-08-09T08:05:24Z', 'timestamp': 1660032324000}, 'update-policy': 'http://dx.doi.org/10.3389/crossmark-policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Risk factors for COVID-19 case fatality rate in people with type 1 and type 2 diabetes mellitus: ' 'A nationwide retrospective cohort study of 235,248 patients in the Russian Federation', 'prefix': '10.3389', 'volume': '13', 'author': [ {'given': 'M. V.', 'family': 'Shestakova', 'sequence': 'first', 'affiliation': []}, {'given': 'O. 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