Diabetes and COVID-19: Inhabitants Influence 18 Months Into the Pandemic

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Diabetes treatment. 07/09/2021: dci210001. doi: 10.2337 / dci21-0001. Online before printing.

ABSTRACT

Eighteen months after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019.) [COVID-19]) Pandemic epidemiological studies show that diabetes plays a central role in the severe COVID-19 morbidity, and conversely, COVID-19 has devastating effects on the population with diabetes. In this literature synthesis, we summarize the relationship of diabetes to COVID-19 related morbidity and mortality, discuss the predictors of serious negative outcomes and impacts of the overall pandemic, and criticize the current status and identify the need for epidemiological studies for the next phase of the pandemic . Case series show that 30-40% of people with COVID-19-related hospitalization, severe morbidity requiring intensive care, and / or death have type 2 or type 1 diabetes. Among hospitalized diabetics, 21-43% required intensive care and the mortality rate is 25%. The risk of severe morbidity and mortality is 100-250% higher in people with diabetes than in people without diabetes, even after adjusting for socio-demographic factors and comorbidities. The impact on the general population with diabetes was similarly severe, with the overall mortality rate 50% higher than the historical trend, a net increase more than twice that of the general population. Of the excess deaths, ∼75-80% are not officially attributed to COVID-19, raising unanswered questions about lack of attribution or collateral impact. Many predictors of poor outcomes have been identified, particularly comorbid conditions (chronic kidney disease, coronary artery disease, and heart failure), concomitant obesity, and acute and chronic poor HbA1c control, indicating the potential for severe morbidity and mortality in its next stages. However, the response to the ongoing pandemic will benefit from population-wide studies with a broader study of the risks of exposure, infection and hospitalization, for which little data is currently available. The indirect effects of the pandemic on health services, health behavior, disease management, care, control and complications have not been well quantified; Determining this impact will be essential to mitigate future impact. Expanding epidemiological studies on the association of diabetes with COVID-19 beyond a few high-income countries will also be essential to limit the burden in low and middle-income countries, where and where 80% of people with diabetes live the COVID-19 pandemic was so damaging.

PMID: 34244333 | DOI: 10.2337 / dci21-0001