The study compared diabetes prevalence in inpatient decedents aged over 65, using a national COVID-19 health record database and Medicare claims for influenza. Diabetes was present in 46.6% of those who died of COVID-19. For influenza deaths the figure was 63.1% once adjusted to the same age mix, so a high diabetes share was not specific to COVID-19.
Why it is interesting: A widely quoted pandemic statistic set against a comparator: those dying of influenza carried more diabetes, not less.
Abstract — the authors' own words, CC BY
Background
Early in the COVID-19 pandemic, mainstream news outlets reported that 30-40% of all coronavirus deaths in the United States occurred among individuals with diabetes. This statistic happens to reflect the approximate prevalence of diabetes in older adults, the age group at highest risk for mortality from COVID-19. To provide greater context to this statistic, we sought to quantify both the proportion of decedents from COVID-19 and from influenza who had diabetes. Methods
For assessing COVID-19 decedents who had diabetes, we used the National COVID Cohort Collaborative (N3C) data enclave, a nationally-representative, harmonized, and de-identified electronic health record database. For assessing influenza decedents who had diabetes, we used Medicare data. We restricted the N3C sample to > 65 years to align with Medicare eligibility. Results
Among older adults with inpatient mortality due to COVID-19, 46.6% (95% CI: 46.1-47.0) had diabetes. Among older adults with inpatient mortality from influenza, the crude percent with diabetes was 61.2%. When age-standardized to match the N3C COVID-19 data, the percentage of influenza decedents with diabetes was 63.1% (95% CI: 59.1-67.1). Conclusions
Among older adults with inpatient mortality from respiratory viruses, a very large proportion had diabetes before infection: 63% of influenza decedents and 47% of COVID-19 decedents. Thus, a high proportion of decedents having diabetes is not new or unique to COVID-19. These findings highlight the value of using available data to contextualize health communication to the public.
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