How Diabetes affects the outcome of COVID-19 Infection


  • Jessica Shekhtman
  • Dr. David Sipe University of Pittsburgh



COVID-19, Type 1 Diabetes, Type 2 Diabetes, Mortality Rates, Odds Ratio


Current literature considers that individuals who have Type 1 and 2 diabetes are a vulnerable group and are at great risk of contracting COVID-19, risking increased complications, and higher mortality rates. Insufficient scientific research data can result in uncertain conclusions. Due to great necessity for quantitative descriptions of trends and predictions, researchers were forced to make assumptions to fill data gaps. The goal of this paper was to minimize uncertainty in the reviewed data outcomes. Varying results could have occurred from lack of research details, confounding factors, and assumptions made throughout data analysis. To resolve these issues, our study is composed of three parts: biological analysis of COVID-19 infection, summary of multiple sources to demonstrate data correlation, consistency with biological conclusions, and quantitative characterization. This study compares calculations of mortality odds ratio (OR) and hazard ratio (HR) fully adjusted for other comorbidities and those not fully adjusted for other comorbidities. Overall diabetes OR not fully adjusted is 3.85, and the fully adjusted one is 1.28. The Type 1 diabetes OR not fully adjusted is 3.51, and the fully adjusted one is 2.39 – 2.86. The Type 2 diabetes OR not fully adjusted is 2.03, and the fully adjusted one is 1.37-1.8. With age, mortality rates for diabetics increase significantly, especially with the presence of other underlying conditions. As an example, the HR calculated for individuals with impaired renal function - eGFR <15 in Type 1 diabetics is 8.35, and in Type 2 diabetics is 4.91.


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Author Biography

Dr. David Sipe, University of Pittsburgh


References or Bibliography

Coronavirus cases. World Meter (https//

Naming the coronavirus disease (COVID-19) and the virus that causes it. World Health Organization, 02, 2020.

A. Sandoiu. Why does SARS-CoV-2 spread so easily. Medical News Today, 03, 2020.

Type 1 diabetes. Mayo Clinic (https//

Type 2 diabetes. Mayo Clinic (https//

Anoop Misra, et al. Diabetes and covid-19: evidence, current status and unanswered research questions. European Journal of Clinical Nutrition, 04, 2020.

Stefanie Gierer, et al. TMPRSS2 and ADAM17 cleave ACE2 differentially and only proteolysis by tmprss2 augments entry driven by the severe acute respiratory syndrome coronavirus spike protein. PMC, 2014.

Caraffa A., et al. Induction of pro-inflammatory cytokines (il-1 and il-6) and lung inflammation by coronavirus-19 (COVID-19 or SARS-CoV-2): anti-inflammatory strategies. Research Gate, 2020.

Evgeniy Choinzonov, et al. Monocytes and macrophages as viral targets and reservoirs. NCBI, 2018.

Marko Kaksonen and Aur´elien Roux. Mechanisms of clathrin-mediated endocytosis. nature reviews molecular biology, 2018.

Deqing Yang, et al. Role of angiotensin-converting enzyme 2 (ace2) in covid-19. BMC, 2020.

Huang, Y., et al. Structural and functional properties of SARS-CoV-2 spike proteins: potential antivirus drug development for Covid-19, Acta Pharmacologica Sinica 41, 1141-1149, 2020

What is the ACE2 receptor, how is it connected to coronavirus and why might it be key to treating covid-19? The Conversation, 2020.

Covid-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet, 2020.

Ayyoub Kihela, et al. The pro-inflammatory cytokines in covid-19 pathogenesis: What goes wrong? Science Direct, 2021.

Deqing Yang, et al. Role of angiotensin-converting enzyme 2 (ACE2) in covid-19. BMC, 2020.

Michael Monostra. Type 1, type 2 diabetes linked to higher odds of covid-19 mortality in England. Healio News, 08, 2020.

Jonathan Valabhji. Type 1 and type 2 diabetes and covid-19 related mortality in England: a whole population study. NHS England, 08, 2020.

Prof Partha Karr, et al. Risk factors for covid 19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. The Lancet, 08, 2020.

Global Data Healthcare. Type 1 diabetes left out of covid-19 conversation, but ripple effects are ongoing. Pharmaceutical Technology, 05, 2021.

Karina Zaiets, and Ramon Padilla, Coronavirus, diabetes, obesity and other underlying conditions: Which patients are most at risk? USA Today, 04, 2020.

Pearson’s correlation coefficient. Statistics Solutions, 2020.

Patrick Lacolley, et al. Vimentin as a target for the treatment of COVID-19. BMJ Open Respiratory Research, 09, 2020.



How to Cite

Shekhtman, J., & Sipe, D. (2023). How Diabetes affects the outcome of COVID-19 Infection. Journal of Student Research, 11(1).



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