Age and Hospitalization Risk in People With Type 1 Diabetes and COVID-19: Data From the T1D Exchange Surveillance Study

Abstract

Context COVID-19 morbidity and mortality are increased in type 1 diabetes (T1D), but few data focus on age-based outcomes. Objective To quantify the risk for COVID-19 related hospitalization and adverse outcomes by age in people with T1D. Design, Setting and Patients For this observational, multisite, cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 56 clinical sites in the United States, data were collected from April 2020 to March 2021. The distribution of patient factors and outcomes across age groups (0-18, 19-40 and > 40 years) was examined. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between age, adverse outcomes, and hospitalization. Main Outcome Measures Hospitalization for COVID-19. Results A total of 767 patients were analyzed. Fifty-four percent (n=415) were aged 0-18 years, thirty-two percent (n=247) were aged 19-40 years and fourteen percent (n=105) were aged >40 years. One-hundred and seventy patients were hospitalized, and 5 patients died. Compared to the 0-18 years age group, those >40 years of age had an adjusted odds ratio of 4.2 (95% confidence interval 2.28-7.83) for hospitalization after adjustment for gender, A1c, race, insurance type and comorbidities. Conclusions Age >40 years is a risk factor for patients with T1D and COVID-19, with children and younger adults experiencing milder disease and better prognosis. This indicates a need for age-tailored treatments, immunization, and clinical management of individuals affected by T1D.

Risk factors for COVID ‐19‐related mortality in hospitalized children and adolescents with diabetes mellitus: An observational retrospective cohort study

“…Few studies have addressed the association of diabetes with the severity of COVID‐19 in children and adolescents. Of note, Demeterco‐Berggren et al 22 reported a multicenter cross‐sectional study of patients with type 1 diabetes and COVID‐19 from 56 clinical centers in the United States. A total of 767 patients were analyzed, of which 415 (54%) were younger than 19 years.…”

Symptoms and Glycemic Control in Young People With Type 1 Diabetes Following SARS-CoV-2 Infection: An Observational Study

“…Similar to our findings, in most cases illness duration lasted 4 to 6 days and longer duration was associated with older children ( 25 , 27 ). COVID-19 disease severity was found to be age related, with increased severity at extremely young age (< 3 months) or above 20 years, with comorbidities such as asthma and gastrointestinal conditions ( 6 ), and in adulthood above age 40 in an age-dependent manner ( 28 ). In a study of adults with T1D, only 0.2% of people were hospitalized with COVID-19 infection, similar to the rate of hospitalization in the general population ( 29 ).…”

Differences in COVID-19 Outcomes Among Patients With Type 1 Diabetes: First vs Later Surges

“…The T1D Exchange Multi-center COVID-19 Surveillance Study collected data from endocrinology clinics that completed a retrospective chart review and submitted information to T1D Exchange via an online questionnaire for all patients with T1D at their sites who tested positive for COVID-19. 13,14 The questionnaire was administered using the Qualtrics survey platform (www. qualtrics.com version XM) and contained 33 pre-coded and free-text response fields to collect patient and clinical attributes.…”