Diabetes mellitus in COVID-19 patients showed a non-significant trend toward higher rates of pulmonary fibrosis at 1 year compared to no diabetes (1.9% vs 0.9%; OR 2.04; 95% CI 0.91-4.58; p=0.08).
Cohort (n=1,866)
No
Does a diagnosis of Diabetes Mellitus increase the risk of developing pulmonary fibrosis 1-year post-COVID-19 in veterans?
There is a trend toward an increased risk of post-COVID-19 pulmonary fibrosis in patients with diabetes mellitus, though the association did not reach statistical significance.
Effect estimate: OR 2.04 (95% CI 0.91-4.58)
Absolute Event Rate: 1.9% vs 0.9%
p-value: p=0.08
Abstract Rationale Diabetes Mellitus (DM) is an identified risk factor for developing complications secondary to COVID-19. Pulmonary fibrosis (PF) is a known long-term complication in patients with COVID-19. It is proposed that DM results in compromised innate cell-mediated immunity and increased proportion of pro-inflammatory cell populations resulting in increased fibrotic disease. However, data regarding the relationship between DM and Post Covid Pulmonary Fibrosis is unclear. Our objective was to examine whether there is an association between DM and the development of PF in patients with COVID-19. We hypothesized that patients with DM that develop COVID-19 are more likely to have a diagnosis of PF one year after COVID-19. Methods We performed a prospective cohort study of veterans diagnosed with COVID-19 from March 13, 2020 through December 31, 2021 at the South Texas Veterans Health Care System. These patients were followed until October 31, 2022 or death. The index date was the first positive Polymerase Chain Reaction (PCR) test for SARS-CoV2 in the inpatient and outpatient setting. We excluded patients that had PF prior or within the first 29 days of presentation and patients who died within the first month of COVID-19. Our variable of interest was patients with a diagnosis of DM compared to patients with no DM. The primary outcome was a new diagnosis of PF 1-year after the index date. Results A total of 2042 patients were enrolled, of whom 176 (8.6%) were excluded due to the above criteria. We included a total of 1866 patients who were stratified into patients with DM (n = 689, 36.9%) and without DM (n = 1177, 63.1%). At baseline, patients with DM, were more likely to have chronic kidney disease, chronic heart failure and an older age. A total of 24 patients (1.3%) developed PF, of which 13 (1.9%) had a prior diagnosis of DM, while 11 (0.9%) had no prior diagnosis of DM (OR 2.04; 95% CI 0.91 - 4.58; p = 0.08). Conclusion Patients with DM tend to have a higher rate of PF 1-year post-COVID-19, compared to patients with no DM. Further studies are needed to assess the risk for individual post COVID-19 sequelae, including PF, in patients with DM. This abstract is funded by: Department of Veterans Affairs
Huston-Cravens et al. (Fri,) conducted a cohort in COVID-19 (n=1,866). Diabetes Mellitus vs. No Diabetes Mellitus was evaluated on New diagnosis of pulmonary fibrosis 1-year after the index date (OR 2.04, 95% CI 0.91-4.58, p=0.08). Diabetes mellitus in COVID-19 patients showed a non-significant trend toward higher rates of pulmonary fibrosis at 1 year compared to no diabetes (1.9% vs 0.9%; OR 2.04; 95% CI 0.91-4.58; p=0.08).