Risk of mortality among inpatients with COVID-19 and type 2 diabetes: National data from Kuwait

Ebaa Al-Ozairi 1 2, Rosemary Brown 3, Yasmine Hamdan 1 4, Lulwa Alabdullah 3, Nia Voase 1, Jumana Al Kandari 1 4, Dalal Alsaeed 1, Abdulla Al Ozairi 5, Amal Hasan 1, Fahd Al-Mulla 6, Srinivasa Vittal Katikireddi 7, Stuart R Gray 3, Jason M R Gill 3, Carlos A Celis-Morales 3, Naveed Sattar 3, Paul Welsh 3

Affiliations

01 October 2021

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doi: 10.1002/edm2.287

Abstract

Introduction: To investigate type 2 diabetes as a risk factor for COVID-19 death following hospital admission in Kuwait.

Methods: A retrospective cohort study using data from a central hospital that cared for all hospitalized COVID-19 patients in Kuwait. We investigated the association between type 2 diabetes, with COVID-19 mortality using multiply imputed logistic regression and calculated the population attributable fraction.

Results: A total of 5333 patients were admitted with COVID-19, of whom 244 died (4.6%). Diabetes prevalence was 24.8%, but 53.7% of those who died had diabetes. After adjusting for age, sex, ethnicity and other comorbidities, diabetes was associated with death (OR 1.70 [95% CI 1.23, 2.34]) and admission to the intensive care unit more than 3 days after initial admission (OR 1.78 [95% CI 1.17, 2.70]). Assuming causality, the population attributable fraction for type 2 diabetes in COVID-19 death was 19.6% (95% CI 10.8, 35.6).

Conclusion: Type 2 diabetes is a strong risk factor for COVID-19 death in the Middle East. Given the high prevalence of type 2 diabetes in the Middle East, as well as many Western countries, the public health implications are considerable.

Keywords: COVID-19; death; diabetes.

Conflict of interest statement

PW has received research grants from Roche Diagnostics, AstraZeneca and Boehringer Ingelheim outside the submitted work, and NS has received grant and personal fees from Boehringer Ingelheim and personal fees from Amgen, AstraZeneca, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer and Sanofi outside the submitted work; all authors declare no other relationships or activities that could appear to have influenced the submitted work.

Figures

FIGURE 1 Temporal pattern of admission to Jaber Al Ahmad Al Sabah hospital for 5333 patients with PCR positive COVID‐19 between 24/02/20 and 15/07/20

FIGURE 1 Temporal pattern of admission to Jaber Al Ahmad Al Sabah hospital for 5333 patients with PCR positive COVID‐19 between 24/02/20 and 15/07/20

FIGURE 2 Proportion of patients with selected comorbidities, separately by COVID‐19 death status

FIGURE 2 Proportion of patients with selected comorbidities, separately by COVID‐19 death status

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