Comorbidities raise COVID-19 hospital risk for children, young adults with type 1 diabetes
Click Here to Manage Email Alerts
For children and young adults with type 1 diabetes, comorbidities such as obesity and asthma increased the risk for COVID-19 hospitalization, according to study results published in Pediatric Diabetes.
“By broadening our understanding of risk factors for severe COVID infection, we are better able to tailor treatment and infection mitigation strategies for our population of youth living with type 1 diabetes,” Elizabeth A. Mann, MD, pediatric endocrinologist and assistant professor in the department of pediatrics at the University of Wisconsin School of Medicine and Public Health, Madison, told Healio. “Having any medical comorbidity increased the risk of severe COVID infection, and comorbidities disproportionately affected those from minoritized racial and ethnic groups. Like in adults, this highlights the role of systemic racism and discrimination in causing more severe COVID outcomes.”
This cross-sectional, multi-institutional surveillance study included questionnaire data on 651 patients (mean age, 15.8 years; 52.1% female) younger than 25 years with type 1 diabetes and laboratory-confirmed COVID-19 from 52 sites in the U.S. between April 2020 and October 2021. Researchers assessed patient factors and COVID-19 outcomes among patients with and without comorbidities.
Researchers observed at least one comorbidity among 31% of patients and more than one among 10% of patients. The most frequently reported comorbidities were obesity in 19% and asthma in 17%. Overall, 17% of patients required hospitalization, and 52% of these patients required admission to the ICU.
Patients with comorbidities were older (mean age, 16.7 vs. 15.4 years) and were less likely to use continuous glucose monitors (60% vs. 70%) compared with patients without comorbidities. Those with at least one comorbidity had almost twice the likelihood of COVID-19 hospitalization compared with patients without comorbidities (OR = 2; 95% CI, 1.3-3.1). This association remained even after adjusting for age, HbA1c, race, ethnicity, insurance type and diabetes duration.
Researchers also observed variations in comorbidity frequency by race and ethnicity: 26% of non-Hispanic white patients, 37% of non-Hispanic Black patients and 41% of Hispanic patients had comordidities. Asthma prevalence was 37% among non-Hispanic Black patients, 12% among non-Hispanic white patients and 15% among Hispanic patients (P = .02). Obesity did not vary significantly by race and ethnicity.
In addition, patients with asthma experienced a nearly three times odds of COVID-19 hospitalization (OR = 2.9; 95% CI, 1.3-6.1), which significantly increased after adjusting for age and HbA1c (OR = 2.7; 95% CI, 1.1-6.4), but not when adjusted for race, ethnicity, insurance type or diabetes duration. Patients with obesity did not experience increased odds of COVID-19 hospitalization.
“We have to better understand the relationship between each of these comorbidities and how they contribute to more severe COVID outcomes, and the role of diabetes in moderating this risk,” Mann said.
For more information:
Elizabeth A. Mann, MD, can be reached at eprange@wisc.edu.
Collapse
Click Here to Manage Email Alerts