The impact of race/ethnicity on the clinical outcomes of people with type 2 diabetes admitted to hospital with COVID-19: an observational multi-national analysis
E. Wilmot, S. Wild, Y. Ruan, S. Hadjadj, M. Wargny, Myia S. Williams, P. Saulnier, Xu Zhu, R. Ryder, R. Pekmezaris, M. Marre, Ben Field, P. Narendran, Sophie Harris, J. Gautier, D. Patel, K. Várnai, J. Davies, R. Roussel, R. Rea, P. Gourdy, B. Cariou, Alyson K. Myers, K. Khunti
{"title":"The impact of race/ethnicity on the clinical outcomes of people with type 2 diabetes admitted to hospital with COVID-19: an observational multi-national analysis","authors":"E. Wilmot, S. Wild, Y. Ruan, S. Hadjadj, M. Wargny, Myia S. Williams, P. Saulnier, Xu Zhu, R. Ryder, R. Pekmezaris, M. Marre, Ben Field, P. Narendran, Sophie Harris, J. Gautier, D. Patel, K. Várnai, J. Davies, R. Roussel, R. Rea, P. Gourdy, B. Cariou, Alyson K. Myers, K. Khunti","doi":"10.15277/bjd.2023.411","DOIUrl":null,"url":null,"abstract":"Aims: To describe the relationship between race/ethnicity and adverse outcomes related to coronavirus disease 2019 (COVID-19) in adults with T2DM admitted to hospital in the UK, France and USA.\nMethods: Study data from the UK ABCD nationwide COVID- 19 audit, the French CORONADO nationwide initiative and the USA AMERICADO multi-centre study were analysed to assess the association between race/ethnicity and severe COVID-19. Severe COVID-19 was defined as death in hospital and/or admission to the intensive care unit (ICU). Logistic regression models were used to generate age-adjusted odds ratios.\nResults: Data from 3,471 patients in the ABCD audit, from 2,451 CORONADO patients and from 9,321 AMERICADO patients admitted with COVID-19 and T2DM were analysed. Race/ethnicity data were available for 3,410 (98%), 2,173 (89%) and 8,893 (95%) patients, respectively. In the UK ABCD audit cohort, Asian and Black race/ethnicity were associated with an increased risk of death/ICU admission compared to White when adjusted for age and sex (OR 2.14; 1.38-3.29 and OR 2.09; 1.17-3.74, respectively). When adjusted for additional confounders the association was stronger (Asian OR 2.88; 1.72-4.82 and Black OR 2.20; 1.12-4.30). In the CORONADO cohort Middle Eastern/North African race/ethnicity was protective against death/ICU admission (OR 0.57; 0.36-0.91).\nThere was no association between ethnicity and death alone in the AMERICADO dataset.\nConclusion: In those with T2DM admitted to hospital with COVID-19, a non-White race/ethnicity was associated with higher risk of death/ICU admission in the UK ABCD data but not in French CORONADO or USA AMERICADO datasets. Further research is required to improve our understanding of the observed discrepancies in outcomes.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.4000,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Diabetes","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15277/bjd.2023.411","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To describe the relationship between race/ethnicity and adverse outcomes related to coronavirus disease 2019 (COVID-19) in adults with T2DM admitted to hospital in the UK, France and USA.
Methods: Study data from the UK ABCD nationwide COVID- 19 audit, the French CORONADO nationwide initiative and the USA AMERICADO multi-centre study were analysed to assess the association between race/ethnicity and severe COVID-19. Severe COVID-19 was defined as death in hospital and/or admission to the intensive care unit (ICU). Logistic regression models were used to generate age-adjusted odds ratios.
Results: Data from 3,471 patients in the ABCD audit, from 2,451 CORONADO patients and from 9,321 AMERICADO patients admitted with COVID-19 and T2DM were analysed. Race/ethnicity data were available for 3,410 (98%), 2,173 (89%) and 8,893 (95%) patients, respectively. In the UK ABCD audit cohort, Asian and Black race/ethnicity were associated with an increased risk of death/ICU admission compared to White when adjusted for age and sex (OR 2.14; 1.38-3.29 and OR 2.09; 1.17-3.74, respectively). When adjusted for additional confounders the association was stronger (Asian OR 2.88; 1.72-4.82 and Black OR 2.20; 1.12-4.30). In the CORONADO cohort Middle Eastern/North African race/ethnicity was protective against death/ICU admission (OR 0.57; 0.36-0.91).
There was no association between ethnicity and death alone in the AMERICADO dataset.
Conclusion: In those with T2DM admitted to hospital with COVID-19, a non-White race/ethnicity was associated with higher risk of death/ICU admission in the UK ABCD data but not in French CORONADO or USA AMERICADO datasets. Further research is required to improve our understanding of the observed discrepancies in outcomes.