Abstract: Factors associated with hospitalization in youths and young adults with type 2 diabetes and COVID-19 infection
E. Tallon1, O. Ebekozien2,3, J. Sanchez4, V. Staggs5,6, D. Ferro5, C.-R. Shyu1, M. Clements5
1University of Missouri-Columbia, Institute for Data Science and Informatics, Columbia, USA, 2T1D Exchange, Boston, USA, 3University of Mississippi, School of Population Health, Jackson, USA, 4University of Miami, Miami, USA, 5Children's Mercy Hospital, Kansas City, USA, 6University of Missouri-Kansas City, Kansas City, USA
Introduction: Considerable research has addressed the impact and increased severity of coronavirus disease 2019 (COVID-19) in adult patients with type 2 diabetes (T2D). However, findings from older adult patients cannot be generalized to affected children and young adults.
Objectives: In this retrospective cohort study, we examine whether race/ethnicity and other factors are associated with hospitalization in pediatric and young adult patients with T2D and COVID-19 infection.
Methods: The de-identified COVID-19 patient cohort from the December 2020 release of Cerner Real-World DataTM includes longitudinal data for patients who received care at 87 US-based health systems between December 2019 and September 2020. A rigorous, multi-step algorithm was used to identify patients with T2D (n=229). Analysis was limited to patients <27 years old with a positive laboratory test or billing code consistent with COVID-19 infection. A generalized linear mixed model was used to evaluate race/ethnicity, gender, HbA1c, body mass index (BMI), mean blood glucose, age, payer, and Elixhauser comorbidity score as correlates of hospital admission.
Results: In this cohort, 204 (89.1%) patients were 18-26 years old, and 133 (58.1%) were female. Fifty-two percent were Hispanic, 27.1% were non-Hispanic Black, and 12.2% were non-Hispanic White. Median BMI was 37.9 kg/m2 (IQR 32.3-45.1 kg/m2); median HbA1c was 9.25% (IQR 7.2-12.3%). Ninety-four patients (41.0%), including all 21 patients in diabetic ketoacidosis (DKA; 9.2%) were hospitalized. Male gender (OR 2.46 [CI 1.23-4.91], p=0.011), HbA1c (OR 1.29 [CI 1.10-1.52], p=0.001), and BMI (OR 1.44 [CI 1.02-2.03], p=0.040) were associated with hospitalization.
Conclusions: Male gender, increased HbA1c, and increased BMI are associated with hospitalization in youths and young adults with T2D and COVID-19 infection. Further study is needed to identify targeted interventions to prevent hospitalization in youths and young adults with T2D.