Prior Glucose-Lowering Medication Use and 30-Day Outcomes Among 64,892 Veterans With Diabetes and COVID-19
Pandora L Wander, Elliott Lowy, Lauren A Beste, Luis Tulloch-Palomino, Anna Korpak, Alexander C Peterson, Steven E Kahn, Edward J Boyko
Diabetes Care, doi:10.2337/dc21-1351
To identify preinfection risk factors for adverse outcomes among veterans with diabetes and coronavirus disease 2019 (COVID-19) infection.
RESEARCH DESIGN AND METHODS We identified all Veterans Health Administration patients with diabetes and one or more positive nasal swab(s) for severe acute respiratory syndrome coronavirus 2 (1 March 2020-10 March 2021) (n = 64,892). We examined associations of HbA 1c and glucose-lowering medication use with hospitalization, intensive care unit (ICU) admission, and mortality at 30 days using logistic regression models and during 4.4 months of follow-up (range <1-13.1) using proportional hazards models.
RESULTS Compared with HbA 1c <7.0%, HbA 1c ‡9.0% was associated with higher odds of hospitalization, ICU admission, and death at 30 days (odds ratio [
Continued on p. 5 Author Contributions. P.L.W. conceived the project, designed the overall research plan, and wrote the first draft of the manuscript. E.L. analyzed the data and reviewed and edited the manuscript. L.A.B. reviewed and edited the manuscript. L.T.-P. reviewed and edited the manuscript. A.K. contributed to design and interpretation of the analyses and reviewed and edited the manuscript. A.C.P. contributed to the design and interpretation of the analyses and reviewed and edited the manuscript. S.E.K. contributed to the design of the analyses and reviewed and edited the manuscript. E.J.B. conceived the project, designed the overall research plan, and reviewed and edited the manuscript. P.L.W. and E.J.B. are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
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