This page is dedicated to the recommendations of the Scientific Council of the CORONADO study for health professionals:
Age a factor in determining the severity of the Covid-19 epidemic
Elderly diabetic patients are particularly affected by the severity of the Covid-19 epidemic because they combine two major severity factors, diabetes and age.
Age is indeed a poor prognostic factor due to the more frequent co-morbidities and the greater susceptibility of seniors to infections. This is evidenced by the low mortality rate of around 0.2% before the age of 40, which in Italy rises to 20.2% after the age of 80. The very high mortality in nursing homes is the most obvious illustration of this, as 50% of deaths occurred in these institutions.
The age of patients with type 2 diabetes is a critical factor in severity. The fact that half of the diabetics are over 65 years old and a quarter over 75 years old shows that these seniors are very numerous, especially in retirement homes where more than 20% of the residents are diabetics. These individuals frequently have co-morbidities and obesity, which are also pejorative factors for Covid-19.
In the CORONADO study, the average age of patients was very close to 70 years and almost half of these patients had complications from diabetes. Thus, age, but also hypertension, micro and macroagiopathic complications, cardiac or respiratory co-morbidities, insulin therapy and RAS blockers were significantly associated with death on day 7. People over 75 years of age had a 14 times greater risk of death than patients under 55 years of age.
However, in multivariate analysis, age was not predictive of the primary endpoint that combined tracheal intubation and/or death within 7 days of admission. This is probably related to the severity of the condition of these patients for whom the indication for intubation has been refuted.
On the other hand, the reassuring results observed in CORONADO regarding the low incidence of the disease during the course of type 1 diabetes is at least partly related to the younger age of these people.
These findings regarding the influence of the age of people with diabetes demonstrate the importance of the barrier measures that have been implemented during the epidemic and the need to maintain them as lockdown ends in France.
