Ten percent of COVID-19 patients with diabetes die within a week of entering the hospital and 20% need a ventilator to breathe by that point, a new French study found.
Researchers analyzed data on more than 1,300 COVID-19 patients with diabetes, average age 70, who were hospitalized in France during March. Of those, 89% had type 2 diabetes, 3% had type 1, and the rest had other types of diabetes.
The study found that 1 in 5 patients had been placed on a ventilator in intensive care within seven days of entering the hospital; 1 in 10 had died; and 18% had been discharged.
"The risk factors for severe form of COVID-19 [in patients with diabetes] are identical to those found in the general population: age and BMI [weight]," said researchers led by diabetes specialists Dr. Bertrand Cariou and Dr. Samy Hadjadj, from University Hospital Nantes.
The study was the first to investigate how COVID-19 affects patients with diabetes.
Poor blood sugar control didn't appear to affect a patient's outcome, but diabetic complications and older age were linked to increased odds of death.
So was a higher body mass index (BMI), an estimate of body fat based on weight and height. Patients with a higher BMI were also more likely to need a ventilator.
The study found that 47% of patients had complications of the eye, kidney or nerves (microvascular), and 41% had complications in the heart, brain and legs (macrovascular).
Those complications each more than doubled a patient's risk of death at day seven of hospitalization, according to the researchers.
Age was also key. Patients 75 years and older were 14 times more likely to die than patients under 55. Patients between 65 and 74 had triple the risk of death compared to those under 55.
In addition, obstructive sleep apnea and shortness of breath almost tripled a patient's risk of death, and higher BMI increased the odds of needing a ventilator or death, the study found.
Women were 25% less likely than men to die or need a ventilator, but the statistical difference was borderline, the researchers said. When they focused on death alone, the risk for men and women was about the same.
The findings were published May 28 in the journal Diabetologia.
The study confirmed that insulin and other treatments for blood sugar control do not increase the odds of severe COVID-19 and should be continued in patients with diabetes, the authors said in a journal news release.
The American Diabetes Association has more on the new coronavirus.