UK Biobank research reveals significant impact of type 2 diabetes on COVID-19 outcomes

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In a recent study published in Communications Biology, a team of scientists investigated how type 2 diabetes and genetic susceptibility to the disease impacted the severity of and mortality risk associated with coronavirus disease 2019 (COVID-19) using data from the United Kingdom (U.K.) Biobank.

Study: Type 2 diabetes and its genetic susceptibility are associated with increased severity and mortality of COVID-19 in UK Biobank. Image Credit: PeopleImages.com - Yuri A/Shutterstock.comStudy: Type 2 diabetes and its genetic susceptibility are associated with increased severity and mortality of COVID-19 in UK Biobank. Image Credit: PeopleImages.com - Yuri A/Shutterstock.com

Background

Despite widespread vaccination across the globe, the COVID-19 pandemic continues, albeit in a less virulent form, with new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

SARS-CoV-2 infections have been found to manifest in a wide range of symptoms, from asymptomatic to severe cases involving acute respiratory distress, pneumonia, and death.

A significant number of COVID-19 cases are also known to progress into post-acute COVID-19 syndrome, commonly known as long coronavirus disease (long COVID).

Extensive research also indicates that clinical factors such as age, smoking behavior, and the presence of comorbidities such as type 2 diabetes, obesity, cardiovascular disease, hypertension, and respiratory diseases are risk factors for severe COVID-19.

Genome-wide association studies have also shown that genetic variants linked to increased risk of cardiovascular disease, type 2 diabetes, lung disease, and those involved in immune mechanisms are associated with a higher risk of severe SARS-CoV-2 infections.

About the study

In the present study, the scientists used U.K. Biobank data to investigate whether type 2 diabetes and polygenic risk scores for type 2 diabetes were associated with increased severity of SARS-CoV-2 infections and a higher COVID-19 mortality rate.

Additionally, they examined the effect of vaccinations on this association and evaluated the impact of numerous SARS-CoV-2 variants, including the recently emerged Omicron variants.

The polygenic risk scores for type 2 diabetes from the genome-wide association study summary statistics obtained from the U.K. Biobank were first used to determine the genetic predisposition for type 2 diabetes.

Here, to account for the confounding impact of body mass index (BMI) on type 2 diabetes, the researchers included BMI as a covariate while calculating the type 2 diabetes polygenic risk scores in the genome-wide association study.

Subsequently, they used the proportional odds models to determine whether type 2 diabetes and the genetic predisposition to type 2 diabetes were associated with increased severity of SARS-CoV-2 infections.

They also examined how type 2 diabetes or the genetic risk for type 2 diabetes impacted survival time when the individual was infected with SARS-CoV-2.

Furthermore, the impact on survival time was reexamined with respect to vaccination status and for a wide range of SARS-CoV-2 variants.

Lastly, the researchers also examined whether mortality rates were significantly different between three groups — COVID-19, type 2 diabetes, and genetic predisposition to type 2 diabetes — using a stratified survivor analysis.

Results

The findings indicated that type 2 diabetes, as well as polygenic risk scores for type 2 diabetes, were associated with increased COVID-19 severity. The mortality rate was also found to be higher for individuals with type 2 diabetes or a genetic predisposition to it.

Based on the time of infection, the mortality rate for type 2 diabetes patients infected with SARS-CoV-2 was two to seven times higher than for those who did not have SARS-CoV-2 infections.

The rate of fatalities was also found to be higher for the early SARS-CoV-2 variants, with the fatality risk decreasing across Alpha, EU1, and Delta variants to the Omicron variants.

Furthermore, vaccinated type 2 diabetes patients had a significantly lower risk of severe SARS-CoV-2 infections than non-vaccinated ones.

The association between polygenic risk scores for type 2 diabetes and increased risk of severe COVID-19 also indicates an interplay between the genetic factors underlying type 2 diabetes and COVID-19, providing potential research avenues to explore to understand the novel genetic factors that are linked to severe SARS-CoV-2 infections.

Conclusions

To summarize, the study examined the relationship between type 2 diabetes or the polygenic risk scores for type 2 diabetes and the odds of developing severe COVID-19.

The findings suggested that individuals who have either the genetic predisposition for or have type 2 diabetes are at an increased risk of severe SARS-CoV-2 infections and a higher risk of mortality due to COVID-19.

However, COVID-19 vaccinations were found to decrease the risk of severe COVID-19 and mortality in these groups.

Journal reference:
Dr. Chinta Sidharthan

Written by

Dr. Chinta Sidharthan

Chinta Sidharthan is a writer based in Bangalore, India. Her academic background is in evolutionary biology and genetics, and she has extensive experience in scientific research, teaching, science writing, and herpetology. Chinta holds a Ph.D. in evolutionary biology from the Indian Institute of Science and is passionate about science education, writing, animals, wildlife, and conservation. For her doctoral research, she explored the origins and diversification of blindsnakes in India, as a part of which she did extensive fieldwork in the jungles of southern India. She has received the Canadian Governor General’s bronze medal and Bangalore University gold medal for academic excellence and published her research in high-impact journals.

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