Clinical features of patients with type 2 diabetes with and without Covid-19: a case control study (CoViDiab I)

Maddaloni, Ernesto; D'Onofrio, Luca; Alessandri, Francesco; Mignogna, Carmen; Leto, Gaetano; Coraggio, Lucia; Sterpetti, Sara; Pascarella, Giuseppe; Mezzaroma, Ivano; Lichtner, Miriam; Pozzilli, Paolo; Eugenio Agrò, Felice; Rocco, Monica; Pugliese, Francesco; Maria Mastroianni, Claudio; Buzzetti, Raffaella

Aims To evaluate whether subjects with diabetes hospitalized for Coronavirus disease-19 (Covid-19) represent a subgroup of patients with high-risk clinical features compared to patients with diabetes without Covid-19. Methods In this case-control study 79 patients with type 2 diabetes out of 354 adults hospitalized for Covid-19 and 158 controls with type 2 diabetes but without Covid-19, matched for age and gender, were enrolled. Medical history and concomitant therapies were retrieved from medical charts and compared between cases and controls, controlling for confounders. Results Fully-adjusted multivariate logistic regression model showed that previous CVD history did not differ between patients with and without Covid-19 (odds ratio 1.40, 95% confidence interval [CI]: 0.59-3.32, p=0.45). A higher prevalence of chronic obstructive pulmonary disease (COPD) (OR 3.72, 95%CI: 1.42-9.72, p=0.007) and of chronic kidney disease (CKD) (OR 3.08, 95%CI: 1.18-8.06, p=0.022) and a lower prevalence of ever smokers (OR 0.30, 95%CI: 0.13-0.67, p=0.003), of users of lipid lowering agents (OR 0.26, 95%CI: 0.12-0.54, p<0.001), and of anti-hypertensive drugs (OR 0.39, 95%CI: 0.16-0.93, p=0.033) were found among cases. Conclusions CVD prevalence does not differ between people with diabetes with and without Covid-19 requiring hospitalization. An increased prevalence of COPD and of CKD in Covid-19 patients with type 2 diabetes is suggested. These findings aid to clarify the relationship between underlying conditions and SARS-CoV-2 infection in the high-risk group of patients with diabetes.