The impact of age on the affiliation between diabetes and mortality in grownup sufferers with COVID-19 in Mexico

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Sci Rep. 2021, April 16; 11 (1): 8386. doi: 10.1038 / s41598-021-88014-z.

ABSTRACT

Diabetes is linked to severe COVID-19 and mortality. The aim of the present study was to determine the influence of age on the association between diabetes and mortality in patients with laboratory-confirmed COVID-19 in Mexico. This retrospective cohort study included patients aged 20 years and over with symptoms of viral respiratory disease who were examined for SARS-CoV-2 infection in the Mexican system for epidemiological monitoring of viral respiratory diseases from January 1 to November 4, 2020. Cox proportional hazard regression was used to calculate the hazard ratio for 28-day mortality and its 95% confidence interval (CI). Among 757,210 patients with COVID-19 (outpatient and inpatient), 120,476 (16%) had diabetes and 80,616 died. Among 878,840 patients without COVID-19 (those who tested negative for SARS-CoV-2 infection), 88,235 (10.0%) had diabetes and 20,134 died. In patients with COVID-19, diabetes was associated with a mortality rate of 1.49 (95% CI 1.47-1.52), taking into account age, gender, smoking habits, obesity, hypertension, immunodeficiency, and cardiovascular, pulmonary, and chronic kidney disease Illness. The strength of the association decreased with age (trend test: P = 0.004). For example, the adjusted risk ratio for death was 3.12 (95% CI 2.86-3.40) for patients aged 20 to 39 years; In contrast, the adjusted hazard ratio of death for patients 80 years and older was 1.11 (95% CI 1.06-1.16). The adjusted hazard ratios were 1.66 (95% CI 1.58-1.74) for outpatients and 1.14 (95% CI 1.12-1.16) for inpatients. No association between diabetes and COVID-19-related mortality was observed in hospital patients aged 80 and over (adjusted hazard ratio: 1.03; 95% CI 0.98-1.08). For patients without COVID-19, the adjusted mortality rate was 1.78 (95% CI 1.73-1.84). In conclusion, among adult patients with COVID-19 in Mexico, the risk of death associated with diabetes decreased with age. No association between diabetes and mortality was observed in inpatients aged 80 years and over. Our results should be checked in other populations.

PMID: 33863997 | DOI: 10.1038 / s41598-021-88014-z