期刊
METABOLISM-CLINICAL AND EXPERIMENTAL
卷 112, 期 -, 页码 -出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.metabol.2020.154344
关键词
Diabetes; Infection; COVID-19; Population cohort
资金
- UK Medical Research Council [MR/P023444/1]
- US National Institute on Aging [1R56AG052519-01, 1R01AG052519-01A1]
- MRC [MR/P023444/1] Funding Source: UKRI
Objective: We aimed to examine the prospective association of diabetes and glycaemic control with COVID-19 hospitalisation in a large community-based cohort study. Methods and study design: Participants (N = 337,802, aged 56.4 +/- 8.1 yr; 55.1% women) underwent biomedical assessments at baseline as part of the UK Biobank prospective cohort study. The outcome was cases of COVID-19 serious enough to warrant a hospital admission from 16-March-2020 to 26-April-2020. Results: At follow up, 649 cases COVID-19 were recorded. In multivariable adjusted analyses, risk of COVID-19 was elevated in people with undiagnosed diabetes at baseline (A1C >= 6.5%) (risk ratio = 2.68; 95% confidence interval: 1.66, 4.33) and poorly controlled (A1C >= 8.6%) diagnosed diabetes (1.91;1.04, 3.52). There was a dose-dependent increase in risk of COVID-19 with increasing A1C, that persisted in multivariable adjusted models (per SD [0.9%]: 1.07; 1.03, 1.11; p[trend] < 0.001). Conclusion: In this large community-based sample, higher levels of A1C within the normal range were a risk factor for COVID-19. Glucose regulation may play a key role in immune responses to this infection. Undiagnosed cases of diabetes in the general community may present a particularly high risk. (C) 2020 Elsevier Inc. All rights reserved.
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