Eli Lilly and Company Indianapolis, Indiana, United States
Background: On March 2020, the Novel Coronavirus Disease (COVID-19) was declared a pandemic by the World Health Organization, and subsequently a national emergency was declared in the US concerning the outbreak.
Objectives: To characterize the epidemiology of COVID-19 in adults with diabetes mellitus (DM).
Methods: Medical claims of adults with DM (≥18 years old) enrolled in the IBM MarketScan database between April 1, 2020 and August 31, 2020 were analyzed to estimate the incidence (per 100 person-years) and period prevalence (percentage) rates of COVID-19 (ICD-10 diagnosis code U07.1) at inpatient and outpatient settings. The corresponding rates of any COVID-19 and hospitalized COVID-19 were calculated for patients with type 1 DM (T1DM, ICD-10 diagnosis code E10) and type 2 DM (T2DM, ICD-10 diagnosis code E11). Rates among patients with T2DM were reported by anti-hyperglycemic classes.
Results: A total of 85,280 patients with T1DM (mean±SD age of 45±16.2 years; 52% males) and 909,340 patients with T2DM (mean±SD age of 57±12 years; 53% males) were included in the analysis. The prevalence rate of any COVID-19 and hospitalized COVID-19 among adults with T1DM (1.8% and 0.4%) and T2DM (2.5% and 0.6%), respectively. The corresponding incidence rates (per 100 person-years) were: T1DM (50.8 and 20) and T2DM (120.3 and 53.6). The age-specific prevalence and incidence rates of any COVID-19 among adults with T2DM: age 18-44 years (3.4% and 190.4); age 45-54 years (2.9% and 159.9); age 55-64 years (2.3% and 116.6); age 65-74 years (1.6% and 60.4); and age ≥75 years (2% and 68.4). The prevalence and incidence rates of any COVID-19 among patients with T2DM by anti-hyperglycemic classes: insulins (2.7% and 97.4); glucagon-like peptide-1 receptor agonists (2.1% and 90.5); dipeptidyl peptidase-4 inhibitors (2.3% and 104.7); sodium-glucose co-transporter-2 inhibitors (2.2% and 101.4); thiazolidinediones (2.1% and 99.5); metformin (2.2% and 110); and sulfonylureas (2.3% and 52.7). The prevalence and incidence (per 100 person-years) rates during same period among adult general population were (prevalence: 1.1% any COVID-19, 0.1% hospitalized COVID-19; incidence: 3.02 any COVID-19, 0.22 hospitalized COVID-19).
Conclusions: Adults with T2DM (especially young patients) have higher prevalence and incidence rates of COVID-19 compared to general population. While pharmacological classes did not show differences in prevalence rates, the incidence of COVID-19 was relatively higher among those treated with earlier steps of hyperglycemic therapy compared to later steps (e.g. metformin vs. insulins), suggesting patients with recently diagnosed T2DM are at high risk for COVID-19 compared to those with established diabetes.
