Epidemiology in older adults of the comorbidity of COVID-19 and type 2 diabetes

Abstract

Older adults were the segment of the population most affected by the COVID-19 pandemic. Type 2 diabetes (DBT2) also has a high prevalence in this age group, and its preexistence increases susceptibility, severity, and mortality from COVID-19. The objectives of this work were to calculate and compare the main epidemiological variables, between groups with DBT2 and without DBT2 in the study population, before and during the COVID-19 pandemic. To determine if there is an association of higher mortality from COVID-19 with the presence of DBT2 in this population of older adults.

Retrospective observational study (2018-2022) of medical records (n=1020) of older adults (≥65 years) treated at the "San Ricardo Pampuri" Center in Villa Carlos Paz. They were statistically analyzed by ANOVA test for quantitative data and Chi-square for categorical data using Infostat (α=0.05). The ethical norms of confidentiality and anonymity were respected.

Population data: Gender distribution=62% male/38% female. 47% of the population suffered from DBT2. Total COVID-19 prevalence: 46% of the population (469 cases) during the study period. COVID-19 incidences (%, DBT2 and non-DBT2 patients respectively): 2020: 25.15 vs 15.78; 2021: 22.95 vs. 14.73; 2022: 11.26 vs. 5.38. COVID-19 mortality (%): Total Average=0.63; in DBT2= 1.00 vs. No DBT2=0.32. 72% of the deceased had DBT2. Annual mortality and fatalities from COVID-19 were higher for those with DBT2. In 2020 and 2021 COVID-19 was the leading cause of death in the population studied. Excess Mortality: Average General Mortality (%) pre-pandemic (2018-2019)=1.86 vs pandemic (2020-2022)=2.72 (46% increase). Average age of death from COVID-19: DBT2=76.4; Not DBT2=84.1. 83% of deceased diabetic patients (2020-2022) were not vaccinated against SARS-COV-2.

The COVID-19 pandemic had a negative impact on the population parameters studied, with these increases being greater in the group with DBT2. An increased mortality risk for COVID-19 was observed in patients with T2DM. In 2022, there was a large decrease in incidence, mortality, and lethality (general and specific for COVID-19) compared to 2021. The improvement of the variables in 2022 coincides with more than 80% of the population covered with vaccines (≥ 2 doses) against SARS-COV-2