COVID-19 fatality rate in patients with diabetes

That the COVID-19 infection, caused by the SARS-CoV-2 virus which has infected over 6.2 million people and claimed more than 375,000 lives globally, is more lethal in immunocompromised people with preexisting comorbidities or advanced age is well known. But now, a French study has attempted to bring out the devastating effects it has been having on people suffering specifically from diabetes.

Severe illness due to the new coronavirus infection is more likely among people living with underlying medical conditions such as diabetes, heart disease, kidney diseases, asthma or different types of cancers, as well as smokers and in the elderly.

Diabetes is an endocrine disorder (hormonal disorder) in which the body does not produce or use the insulin hormone effectively. It is mainly broken up into type 1 and type 2 (besides gestational diabetes in pregnant women and prediabetes), and can affect people of all ages and doesn't have any cure as such, although its symptoms can be managed through proper medical care and a controlled lifestyle.

The emergence of the COVID-19 infection has put added strain on people living with comorbidities and put them at a higher risk of developing more severe symptoms and a higher risk of fatality.

New study highlights COVID-19 fatality risk for people with diabetes
COVID-19 and asthma
COVID-19 and heart disease

New study highlights COVID-19 fatality risk for people with diabetes

The French study found that one in 10 diabetics who contracted COVID-19 and became sick enough to go to a hospital, died within seven days of being hospitalised—that is a mortality rate of 10% of diabetic COVID-19 patients who got hospitalised! Further, the study found that one in five diabetic COVID-19 patients had to be put on a ventilator for breathing support.

This study is the first to look specifically into the subject of COVID-19 mortality risk in patients with diabetes. It was published in the journal Diabetologica and titled "Phenotype characteristics and prognosis of inpatients with COVID-19 and diabetes".

That said, other studies for comorbidities like heart disease and COVID-19 have found similarly bleak data. On 1 May 2020, research published in the New England Journal of Medicine showed that among 8,910 COVID-19 patients admitted in 169 hospitals across Asia, Europe and North America, the mortality rate was significantly higher in patients with coronary artery disease (10.2%), heart failure (15.3%) and cardiac arrhythmia or irregular heartbeat (11.5%) compared with under 6% for people who didn't have the respective diseases.

CORONADO study

The new study was performed countrywide in France and was called CORONADO, short for coronavirus and diabetes outcomes, and aimed to assess the health of patients and find out in detail the factors behind the development of severe symptoms of COVID-19 in diabetes patients.

As many as 1,317 patients were part of the study across 53 hospitals in France between 10 March and 31 March 2020, and a significant majority of the patients were diagnosed with type 2 diabetes (89%), about 3% patients with type 1 diabetes and the remaining patients diagnosed with the other types of the disease. A small percentage (3%) were diagnosed with diabetes only after they were admitted to the hospital.

Another unique outcome of the study was that it found as many as 65% of COVID-19 patients with diabetes were men and were over the age of 70 years, and even though poor blood sugar levels didn't contribute to the patient's outcome, complications arising from diabetes and advanced age did increase the chances of fatality. A high BMI (body mass index) is usually associated with a higher risk of intubation or mechanical ventilation due to the increased difficulty in breathing and, as a result, a higher risk of death. (Read more: Obesity)

However, the doctors behind the study also noted that more research would be needed to establish a more concrete relationship between obesity and the respiratory infection to be able to prevent or control the risk of a negative outcome among patients.

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COVID-19 and asthma

While early data on COVID-19 cases suggested that chronic pulmonary diseases such as asthma were underrepresented, new evidence through studies and research suggest asthma patients with COVID-19 do not have a higher rate of hospitalization or mortality, as compared to COVID-19 patients with other comorbidities.

According to statistics from New York's State Department of Health, asthma is not even in the top 10 underlying illnesses despite the fact that as many as 8% to 10% of people living in the city have asthma. Even COPD was reported to be behind conditions such as diabetes, hypertension and other heart diseases, dementia and renal or kidney diseases in terms of causing serious illness due to COVID-19.

Another study from Wuhan, where the COVID-19 infection is believed to have originated from, noted a 0.9% prevalence of COVID-19 patients with asthma.

COVID-19 and heart disease

Although a vast majority of COVID-19 patients—about 80%—only develop mild, flu-like symptoms of the disease, the remaining 20% do develop severe symptoms that require hospitalization and another fourth of those needing intensive care. However, recent studies have also delved into the risk heart patients face if they contract the COVID-19 infection.

Studies in Italy have pointed to high percentages of patients who died having had heart-related comorbidities, with 71% of patients having hypertension, 28% having coronary artery disease and 16% having heart failure.