medwireNews: A large UK study using the OpenSAFELY analytics platform has found that people with diabetes, particularly those with poor glycemic control, may have an elevated risk for COVID-19-related death.
As reported in Nature, Ben Goldacre (University of Oxford, UK) and co-researchers created OpenSAFELY as a secure method to analyze pseudonymized electronic medical records. They used primary care data from 17,278,392 adults, 10,926 (0.06%) of whom died and had COVID-19 recorded on their death certificate, to identify clinical risk factors for COVID-19 mortality.
Among people with diabetes, 0.23% of the 1,038,082 individuals with glycated hemoglobin (HbA1c) levels below 58 mmol/mol (7.5%) experienced COVID-19-related death, as did 0.26% of the 486,491 with HbA1c levels at or above this threshold, and 0.23% of the 193,993 with no recent HbA1c measurement. These rates translated into significant hazard ratios of 1.31, 1.95, and 1.90, respectively, relative to people without diabetes after adjustment for factors including age, sex, BMI, and comorbidities.
The study also confirmed that older age was strongly associated with increased mortality risk, with people aged 80 years and older having more than a 20-fold increased risk than those aged 50–59 years. Male sex, Black and South Asian ethnicity, obesity, and a range of conditions including severe asthma, auto-inflammatory diseases, and chronic heart disease were also linked to COVID-19 mortality risk.
These findings “may be used subsequently to inform the development of prognostic models,” say Goldacre and team, but they “caution against interpreting [the] estimates as causal effects.”
medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group
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