ArticleBMJ open2024
Risk factor associations for severe COVID-19, influenza and pneumonia in people with diabetes to inform future pandemic preparations: UK population-based cohort study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 11 citations in OpenAlex.
- Higher Body Mass Index Is a Causal Risk Factor for Skin Infections: A Mendelian Randomisation Study Using UK Biobank and FinnGen.Diabetes, obesity & metabolism · 2026Observational
- Determinants of COVID-19 and Influenza Vaccination Among People with Diabetes Mellitus in Primary Health Care.Vaccines · 2026Article
- Type 2 diabetes and the risk of hospitalisation and mortality from seasonal influenza: an observational register-based study in Sweden.BMJ open · 2026Observational
- Association Between Sodium-Glucose Cotransporter-2 Inhibitors and Sepsis Risk in Patients With Type 2 Diabetes Mellitus.Journal of diabetes research · 2026Article
- Awareness, uptake, and barriers to vaccination against respiratory tract infections in patients with diabetes mellitus: A multi-center study in Saudi Arabia.Human vaccines & immunotherapeutics · 2025Article
- IL-10- and IL-13-Biased T Cell Responses to SARS-CoV-2 Vaccination in Diabetes.European journal of immunology · 2025Article
- Body mass index and infection risks in people with and without type 2 diabetes: A cohort study using electronic health records.International journal of obesity (2005) · 2025Article
- Article
- Hospitalisation from seasonal influenza among persons with type 1 diabetes: a cohort study from the Swedish National Diabetes Register.BMJ open · 2025Article
- Impact of the COVID-19 Pandemic on Psychosocial Distress in Adolescents with Obesity Compared to Those with Type 1 Diabetes: Results from the KICK-COVID Study in Germany.Obesity facts · 2025Article
- Exploring genetic loci linked to COVID-19 severity and immune response through multi-trait GWAS analyses.Frontiers in genetics · 2025Article
- Pathology of Diabetes-Induced Immune Dysfunction.International journal of molecular sciences · 2024Review
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveThis study aimed to compare clinical and sociodemographic risk factors for severe COVID-19, influenza and pneumonia, in people with diabetes.
designPopulation-based cohort study.
settingUK primary care records (Clinical Practice Research Datalink) linked to mortality and hospital records.
participantsIndividuals with type 1 and type 2 diabetes (COVID-19 cohort: n=43 033 type 1 diabetes and n=584 854 type 2 diabetes, influenza and pneumonia cohort: n=42 488 type 1 diabetes and n=585 289 type 2 diabetes). PRIMARY AND SECONDARY OUTCOME MEASURES: COVID-19 hospitalisation from 1 February 2020 to 31 October 2020 (pre-COVID-19 vaccination roll-out), and influenza and pneumonia hospitalisation from 1 September 2016 to 31 May 2019 (pre-COVID-19 pandemic). Secondary outcomes were COVID-19 and pneumonia mortality. Associations between clinical and sociodemographic risk factors and each outcome were assessed using multivariable Cox proportional hazards models. In people with type 2 diabetes, we explored modifying effects of glycated haemoglobin (HbA1c) and body mass index (BMI) by age, sex and ethnicity.
resultsIn type 2 diabetes, poor glycaemic control and severe obesity were consistently associated with increased risk of hospitalisation for COVID-19, influenza and pneumonia. The highest HbA1c and BMI-associated relative risks were observed in people aged under 70 years. Sociodemographic-associated risk differed markedly by respiratory infection, particularly for ethnicity. Compared with people of white ethnicity, black and south Asian groups had a greater risk of COVID-19 hospitalisation, but a lesser risk of pneumonia hospitalisation. Risk factor associations for type 1 diabetes and for type 2 diabetes mortality were broadly consistent with the primary analysis.
conclusionsClinical risk factors of high HbA1c and severe obesity are consistently associated with severe outcomes from COVID-19, influenza and pneumonia, especially in younger people. In contrast, associations with sociodemographic risk factors differed by type of respiratory infection. This emphasises that risk stratification should be specific to individual respiratory infections.
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