Hospitalization and mortality in patients with COVID-19 with or at risk of type 2 diabetes: data from five health systems in Pennsylvania and Maryland
et al., BMJ Open Diabetes Research & Care,
Retrospective 4,944 COVID-19 patients with type 2 diabetes in the USA, showing lower risk of hospitalization and combined ICU/intubation/death with metformin use.
ICU/intubation/death, 44.0% lower, OR 0.56, p < 0.001, RR approximated with OR.
risk of hospitalization, 37.0% lower, OR 0.63, p < 0.001, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yeh et al., 9 Jun 2022, retrospective, USA, peer-reviewed, mean age 62.3, 9 authors, study period 1 March, 2020 - 28 February, 2021, trial NCT02788903 (history)
Abstract: Original research
Hospitalization and mortality in
patients with COVID-19 with or at risk
of type 2 diabetes: data from five health
systems in Pennsylvania and Maryland
Hsin-Chieh Yeh ,1 Jennifer L Kraschnewski,2,3 Lan Kong,3 Erik B Lehman,3
Emily S Heilbrunn,2 Pamela Williams,4 Jennifer M Poger,2 Erica Francis,2
Cindy L Bryce5
To cite: Yeh H-C,
Kraschnewski JL, Kong L, et al.
Hospitalization and mortality
in patients with COVID-19
with or at risk of type 2
diabetes: data from five health
systems in Pennsylvania and
Maryland. BMJ Open Diab
Res Care 2022;10:e002774.
► Additional supplemental
material is published online
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journal online (http://d x.doi.
Received 18 January 2022
Accepted 16 May 2022
© Author(s) (or their
employer(s)) 2022. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published
For numbered affiliations see
end of article.
Objective To identify the demographic and clinical
characteristics associated with adverse COVID-19
outcomes across a 12-month period in 2020 and 2021.
Research design and methods We conducted a
retrospective cohort study using electronic health records
from five academic health systems in Pennsylvania
and Maryland, including patients with COVID-19 with
type 2 diabetes or at risk of type 2 diabetes. Patients
were classified based on 30-day outcomes: (1) no
hospitalization; (2) hospitalization only; or (3) a composite
measure including admission to the intensive care unit
(ICU), intubation, or death. Analyses were conducted in
patients with type 2 diabetes and patients at risk of type 2
Results We included 15 725 patients with COVID-19
diagnoses between March 2020 and February 2021.
Older age and higher Charlson Comorbidity Index scores
were associated with higher odds of adverse outcomes,
while COVID-19 diagnoses later in the study period were
associated with lower odds of severe outcomes. In patients
with type 2 diabetes, individuals on insulin treatment had
higher odds for ICU/intubation/death (OR=1.59, 95% CI
1.27 to 1.99), whereas those on metformin had lower
odds (OR=0.56, 95% CI 0.45 to 0.71). Compared with
non-Hispanic White patients, Hispanic patients had higher
odds of hospitalization in patients with type 2 diabetes
(OR=1.73, 95% CI 1.36 to 2.19) or at risk of type 2
diabetes (OR=1.77, 95% CI 1.43 to 2.18.)
Conclusions Adults who were older, in racial minority
groups, had multiple chronic conditions or were on insulin
treatment had higher risks for severe COVID-19 outcomes.
This study reinforced the urgency of preventing COVID-19
and its complications in vulnerable populations.
Trial registration number NCT02788903.
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