Diabetes is a co-morbidity factor of Covid-19 identified fairly early in the epidemic. A study carried out in more than 50 hospitals with diabetic patients allows us to determine which profile is most at risk.
Since the beginning of the Covid-19 epidemic, diabetes has been known to be an important co-morbidity factor with, among others, obesity and hypertension. But the term diabetes describes two very different pathologies: one is an autoimmune disease, it is type 1 diabetes, and the other is diet-related, it generally appears with age, it is type 2 diabetes.
Precisely which diabetes is most at risk and which part of the population is most likely to contract a severe form of Covid-19, 51 French hospitals participated in the Coronado (Coronavirus Sars-CoV-2 and Diabetes Outcomes) study which took place last March. The results of the study were published in the specialist journal Diabetologia.
Type 2 diabetes is the most common
More than 1,300 patients who were seropositive for Sars CoV-2 and with a long history of diabetes or a recent diagnosis were considered in the Coronado study. Men represented 64.9% of the sample and the median age was 69.8 years. At the beginning of the follow-up, the majority of patients, 907 people, were not being treated in the intensive care unit, the remaining 410 people were, with or without tracheal intubation. Physicians then provided an update on their health status at day seven.
What is the diabetic profile of these patients?
The overwhelming majority, 88.5%, of the people in the Coronado study had type 2 diabetes. This diabetes, which is not insulin-dependent, is characterized by hyperglycemia, or too high a level of sugar in the blood. It appears with age and onset around the age of 50. On the other hand, type 1 diabetes affects only 3% of the Coronado study population.
A combination of co-morbidity factors
Unfortunately, type 2 diabetes is often associated with other co-morbidity factors that make people particularly vulnerable to Covid-19: 77% of patients also suffer from hypertension and 51% from dyslipidemia, too high a cholesterol level in the blood. Finally, the median BMI of patients is 28.4, which, according to standards, corresponds to overweight.
Of the patients included in the study, 20.3% required tracheal intubation and mechanical ventilation. And 10.6% died before Day 7, while patients were hospitalized only 5 days after the onset of symptoms. These premature deaths occurred mainly in patients over 75 years of age. No person under 65 years of age with type 1 diabetes died during the study.
In conclusion, elderly men with long-standing type 2 diabetes and associated complications are particularly vulnerable to Covid-19.