Key result
Diabetes mellitus and obesity independently increased risk of intubation, ICU admission, or mortality in COVID-19 inpatients (HR 1.14, 95% CI 1.01-1.30 and HR 1.22, 95% CI 1.05-1.43, respectively).
Why the study?
To assess whether diabetes mellitus or obesity is an independent risk factor for severe COVID-19 outcomes and whether the risk conferred by one condition is modified by the other.
Do diabetes mellitus and obesity independently increase the risk of intubation, ICU admission, or in-hospital mortality in inpatient adults with COVID-19?
Cohort (n=3,533)
Do diabetes mellitus and obesity independently increase the risk of intubation, ICU admission, or in-hospital mortality in inpatient adults with COVID-19?
Hazard Ratio: 1.14 (95% CI 1.01–1.3)
Diabetes and obesity are independent risk factors for severe COVID-19 outcomes, with obesity potentially conferring greater risk in patients with diabetes.
DM or obesity may heighten severe COVID-19 risk; leaves open independent effects and interactions pending prospective data.
OBJECTIVE: This study aimed to assess whether diabetes mellitus (DM) or obesity is an independent risk factor for severe coronavirus disease 2019 (COVID-19) outcomes and to explore whether the risk conferred by one condition is modified by the other. METHODS: This retrospective cohort study of inpatient adults with COVID-19 used multivariable Cox regression to determine the independent effects of DM and obesity on the composite outcome of intubation, intensive care unit admission, or in-hospital mortality. Effect modification between DM and obesity was assessed with a statistical interaction term and an exploration of stratum-specific effects. RESULTS: Out of 3,533 patients, a total of 1,134 (32%) had DM, 1,256 (36%) had obesity, and 430 (12%) had both. DM and obesity were independently associated with the composite outcome (hazard ratio [HR] 1.14 [95% CI: 1.01-1.30] and HR 1.22 [95% CI: 1.05-1.43], respectively). A statistical trend for potential interaction between DM and obesity was observed (P = 0.20). Stratified analyses showed potential increased risk with obesity compared with normal weight among patients with DM (HR 1.34 [95% CI: 1.04-1.74]) and patients without DM (HR 1.18 [95% CI: 0.96-1.43]). CONCLUSIONS: DM and obesity are independent risk factors associated with COVID-19 severity. Stratified analyses suggest that obesity may confer greater risk to patients with DM compared with patients without DM, and this relationship requires further exploration.
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Tchang et al. (2021) conducted a cohort in COVID-19 (n=3,533). Diabetes mellitus vs. Without diabetes mellitus was evaluated on Composite outcome of intubation, intensive care unit admission, or in-hospital mortality (HR 1.14, 95% CI 1.01-1.30). Diabetes mellitus and obesity independently increased risk of intubation, ICU admission, or mortality in COVID-19 inpatients (HR 1.14, 95% CI 1.01-1.30 and HR 1.22, 95% CI 1.05-1.43, respectively).
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