COVID-19 patients with both type 2 diabetes and heart disease have greater risk of death

Results from a recent study have the potential to inform treatment and care strategies for individuals with type 2 diabetes mellitus and cardiovascular disease diagnosed with COVID-19.

Wilmington, DE – June 6, 2022 – COVID-19 patients with both type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) showed significantly higher rates of mortality, intensive care unit (ICU) admissions, and hospitalizations compared to COVID-19 patients with neither T2DM nor CVD. The study, by Carelon Research, Boehringer Ingelheim and Elevance Health -- also found the cost per patient was higher in COVID-19 patients with T2DM and CVD compared to individuals without either disease. The findings were presented at the American Diabetes Association Scientific Sessions 2022 in New Orleans.

“We know that diabetes alone and CVD alone are risk factors for severe COVID-19 and mortality,” said Mark Cziraky, president of Carelon Research, the outcomes research subsidiary of Elevance Health. “Through this collaboration we were able to quantify the incremental risk among this subset of COVID-19 patients with T2DM and CVD.”

This observational study compared clinical and economic outcomes of COVID-19 patients with and without T2DM and CVD. Researchers used existing claims and lab data from the Healthcare Integrated Research Database (HIRD®) of commercially insured and Medicare patients with COVID-19 between March 1, 2020 and May 31, 2021. Patients were grouped by those having no T2DM or CVD, having T2DM only, and having both T2DM and CVD. The primary outcomes included hospital/ICU admission and mortality following COVID-19 infection. Propensity score matching and multivariable analyses were performed. After matching, 6,967 patients were identified for each group with a mean follow-up of 5.4 months.

A greater percentage of patients with T2DM and CVD had at least one COVID-19-related hospitalization compared to COVID-19 patients without T2DM or CVD (27.7% vs. 17.3%). Patients with T2DM and CVD also had a 26% higher mortality rate, were 59% more likely to be hospitalized, and 74% more likely to be admitted to the ICU after accounting for baseline differences between cohorts. In this analysis, the increased utilization of healthcare resources contributed to higher costs. Researchers found that COVID-19 patients with T2DM and CVD had higher mean COVID-19-related healthcare costs per month after COVID-19 infection compared to COVID-19 patients without either condition ($9,290 vs. $5,498).

The study also showed that COVID-19 patients with T2DM only used the healthcare system more than COVID-19 patients without T2DM or CVD, but not as much as individuals with both conditions. Compared to patients with no T2DM or CVD, patients with T2DM only were 28% more likely to be hospitalized and 32% more likely to be admitted to the ICU after accounting for baseline differences between cohorts. No significant difference was observed between those with COVID-19 with T2DM only and those without T2DM or CVD in terms of survival. In terms of healthcare costs, COVID-19 patients with T2DM had higher mean costs than patients without either T2DM or CVD ($6,091 vs. $5,498).

“The results of this study emphasize the critical need for a more aggressive triage and management approach for people with T2DM and CVD given the significantly higher risk of hospitalization and mortality following COVID-19 infection,” said Mohamed Eid, M.D., M.P.H., M.H.A., vice president, Clinical Development & Medical Affairs, Cardio-Metabolism & Respiratory Medicine, Boehringer Ingelheim Pharmaceuticals, Inc. “By delivering the right prevention and treatment to the right individual at the right time, we can improve outcomes for this vulnerable population.”

This study is the most recent work coming out of the large-scale research collaboration between Elevance Health, Boehringer Ingelheim, and Carelon Research to generate real-world evidence to help inform the development of new medicines, standard of care, and interventions.