Coronavirus: older diabetics most at risk

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Diabetes is a co-morbidity factor for Covid-19 that was identified fairly quickly at the start of the epidemic. A study carried out in more than 50 hospitals with diabetic patients makes it possible to determine which profile is most at risk.

Since the beginning of the Covid-19 epidemic, diabetes has been known to be an important factor in comorbidity, with obesity and hypertension, among others. But the term diabetes describes two very different pathologies: one is an autoimmune disease, it is type 1 diabetes, and the other is linked to food, it generally appears with age, c is type 2 diabetes.

To understand a little more precisely which diabetes is most at risk and which part of the population is most likely to contract a severe form of Covid-19, 51 French hospitals participated in the Coronado study (Coronavirus Sars-CoV- 2 and Diabetes Outcomes) which took place last March. The results of the study were published in the specialized journal Diabetologia.

Type 2 diabetes is the most common

More than 1,300 patients who were seropositive to Sars-CoV-2 and with a long diabetic liability or a recent diagnosis were considered in the Coronado study. Males make up 64.9% of the sample and the median age is 69.8 years. At the start of follow-up, the majority of patients, 907 people, were not treated in the intensive care unit, the other 410 people were, with or without tracheal intubation. The doctors then gave an update on their state of health on the seventh day.

What is the diabetic profile of these patients?

The overwhelming majority, 88.5%, of the people considered in the Coronado study suffer from type 2 diabetes. This diabetes, which is not dependent on insulin, is characterized by hyperglycemia, a rate too much blood sugar. It appears with age and occurs around 50 years of age. Conversely, type 1 diabetes concerns only 3% of the workforce in the Coronado study.

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A combination of comorbidity factor

Unfortunately, type 2 diabetes is often associated with other comorbidity factors that make people particularly fragile when faced with Covid-19: 77% of patients also suffer from hypertension and 51% from dyslipidemia, too high cholesterol in the blood. Finally, the median BMI of the patients is 28.4, which, by standards, corresponds to being overweight.

Of the patients included in the study, 20.3% required tracheal intubation and mechanical ventilation. And 10.6% died before the seventh day, while the patients were hospitalized only 5 days after the onset of symptoms. These premature deaths mainly concern patients over 75 years of age. No one under the age of 65 with type 1 diabetes died during the study.

In conclusion, elderly men with long-standing type 2 diabetes, and associated complications, are particularly vulnerable to Covid-19.


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