PMID- 37423628
OWN - NLM
STAT- MEDLINE
DCOM- 20230711
LR  - 20230718
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 13
IP  - 7
DP  - 2023 Jul 9
TI  - Diabetes status and other factors as correlates of risk for thrombotic and 
      thromboembolic events during SARS-CoV-2 infection: A nationwide retrospective 
      case-control study using Cerner Real-World Data.
PG  - e071475
LID - 10.1136/bmjopen-2022-071475 [doi]
LID - e071475
AB  - OBJECTIVES: We sought to examine in individuals with SARS-CoV-2 infection whether 
      risk for thrombotic and thromboembolic events (TTE) is modified by presence of a 
      diabetes diagnosis. Furthermore, we analysed whether differential risk for TTEs 
      exists in type 1 diabetes mellitus (T1DM) versus type 2 diabetes mellitus (T2DM). 
      DESIGN: Retrospective case-control study. SETTING: The December 2020 version of 
      the Cerner Real-World Data COVID-19 database is a deidentified, nationwide 
      database containing electronic medical record (EMR) data from 87 US-based health 
      systems. PARTICIPANTS: We analysed EMR data for 322 482 patients >17 years old 
      with suspected or confirmed SARS-CoV-2 infection who received care between 
      December 2019 and mid-September 2020. Of these, 2750 had T1DM; 57 811 had T2DM; 
      and 261 921 did not have diabetes. OUTCOME: TTE, defined as presence of a 
      diagnosis code for myocardial infarction, thrombotic stroke, pulmonary embolism, 
      deep vein thrombosis or other TTE. RESULTS: Odds of TTE were substantially higher 
      in patients with T1DM (adjusted OR (AOR) 2.23 (1.93-2.59)) and T2DM (AOR 1.52 
      (1.46-1.58)) versus no diabetes. Among patients with diabetes, odds of TTE were 
      lower in T2DM versus T1DM (AOR 0.84 (0.72-0.98)). CONCLUSIONS: Risk of TTE during 
      COVID-19 illness is substantially higher in patients with diabetes. Further, risk 
      for TTEs is higher in those with T1DM versus T2DM. Confirmation of increased 
      diabetes-associated clotting risk in future studies may warrant incorporation of 
      diabetes status into SARS-CoV-2 infection treatment algorithms.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Tallon, Erin M
AU  - Tallon EM
AUID- ORCID: 0000-0003-1353-6632
AD  - Institute for Data Science and Informatics, University of Missouri, Columbia, 
      Missouri, USA etallon@cmh.edu.
AD  - Department of Pediatrics - Division of Pediatric Endocrinology and Diabetes, 
      Children's Mercy Kansas City, Kansas City, Missouri, USA.
FAU - Gallagher, Mary Pat
AU  - Gallagher MP
AD  - Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, 
      New York, New York, USA.
FAU - Staggs, Vincent S
AU  - Staggs VS
AD  - Department of Pediatrics - Division of Health Services and Outcomes Research, 
      Children's Mercy Kansas City, Kansas City, Missouri, USA.
AD  - Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 
      Kansas City, Missouri, USA.
FAU - Ferro, Diana
AU  - Ferro D
AD  - Department of Pediatrics - Division of Pediatric Endocrinology and Diabetes, 
      Children's Mercy Kansas City, Kansas City, Missouri, USA.
AD  - Bambino Gesu Children's Hospital, IRCCS, Rome, Italy.
FAU - Murthy, Deepa Badrinath
AU  - Murthy DB
AD  - Department of Pediatrics, Hassenfeld Children's Hospital at NYU Langone Health, 
      New York, New York, USA.
FAU - Ebekozien, Osagie
AU  - Ebekozien O
AD  - T1D Exchange, Boston, Massachusetts, USA.
AD  - School of Population Health, University of Mississippi, Jackson, Mississippi, 
      USA.
FAU - Kosiborod, Mikhail N
AU  - Kosiborod MN
AD  - Department of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, 
      Kansas City, Missouri, USA.
AD  - University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, 
      USA.
FAU - Lind, Marcus
AU  - Lind M
AD  - Department of Molecular and Clinical Medicine, University of Gothenburg, 
      Gothenburg, Sweden.
AD  - Department of Medicine, NU-Hospital Group, Trollhattan and Uddevalla, Sweden.
AD  - Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
FAU - Manrique-Acevedo, Camila
AU  - Manrique-Acevedo C
AD  - Department of Medicine - Division of Endocrinology, Diabetes and Metabolism, 
      University of Missouri, Columbia, Missouri, USA.
FAU - Shyu, Chi-Ren
AU  - Shyu CR
AD  - Institute for Data Science and Informatics, University of Missouri, Columbia, 
      Missouri, USA.
AD  - Department of Electrical Engineering and Computer Science, University of 
      Missouri, Columbia, Missouri, USA.
FAU - Clements, Mark A
AU  - Clements MA
AD  - Department of Pediatrics - Division of Pediatric Endocrinology and Diabetes, 
      Children's Mercy Kansas City, Kansas City, Missouri, USA.
AD  - Department of Pediatrics, University of Missouri-Kansas City School of Medicine, 
      Kansas City, Missouri, USA.
LA  - eng
GR  - T32 LM012410/LM/NLM NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20230709
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Humans
MH  - Adolescent
MH  - *Diabetes Mellitus, Type 1/complications/epidemiology
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - Retrospective Studies
MH  - *COVID-19/complications/epidemiology
MH  - Case-Control Studies
MH  - SARS-CoV-2
MH  - *Thromboembolism/epidemiology/etiology
MH  - Risk Factors
PMC - PMC10335498
OTO - NOTNLM
OT  - COVID-19
OT  - DIABETES & ENDOCRINOLOGY
OT  - Health informatics
OT  - Stroke
OT  - Thromboembolism
COIS- Competing interests: MAC is the Chief Medical Officer at Glooko. He receives 
      research support from Dexcom and Abbott Diabetes Care. MNK receives, or has 
      received, research grant support from AstraZeneca and Boehringer Ingelheim, as 
      well as other research support form AstraZeneca. He receives, or has received, 
      research honoraria from AstraZeneca, Boehringer Ingelheim and Novo Nordisk. He 
      serves, or has served, as a consultant and/or advisor for Alnylam, Amgen, 
      AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Eli Lilly, Esperion 
      Therapeutics, Janssen, Lexicon, Merck (Diabetes and Cardiovascular), Novo 
      Nordisk, Pharmacosmos, Sanofi and Vifor Pharma. He has received support for 
      attending meetings and/or travel from AstraZeneca, Bayer, Boehringer Ingelheim 
      and Novo Nordisk, and he participated on an advisory board for Applied 
      Therapeutics.
EDAT- 2023/07/10 00:41
MHDA- 2023/07/11 06:41
PMCR- 2023/07/09
CRDT- 2023/07/09 20:43
PHST- 2023/07/11 06:41 [medline]
PHST- 2023/07/10 00:41 [pubmed]
PHST- 2023/07/09 20:43 [entrez]
PHST- 2023/07/09 00:00 [pmc-release]
AID - bmjopen-2022-071475 [pii]
AID - 10.1136/bmjopen-2022-071475 [doi]
PST - epublish
SO  - BMJ Open. 2023 Jul 9;13(7):e071475. doi: 10.1136/bmjopen-2022-071475.