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Diabetes increases the risk of COVID-19 in an altitude dependent manner: An analysis of 1,280,806 Mexican patients

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dc.contributor.author Leon-Abarca, Juan Alonso
dc.contributor.author Portmann Baracco, Arianna Sibila
dc.contributor.author Bryce-Alberti, M.
dc.contributor.author Ruiz-Sánchez, C.
dc.contributor.author Accinelli Tanaka, Roberto Alfonso
dc.contributor.author Soliz, J.
dc.contributor.author Gonzales Rengifo, Gustavo Francisco
dc.date.accessioned 2021-10-04T23:00:57Z
dc.date.available 2021-10-04T23:00:57Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9812
dc.description.abstract Aims The objective of this study is to analyze how the impact of Diabetes Mellitus [DM] in patients with COVID-19 varies according to altitudinal gradient. Methods We obtained 1,280,806 records from adult patients with COVID-19 and DM to analyze the probability of COVID-19, development of COVID-19 pneumonia, hospitalization, intubation, admission to the Intensive Care Unit [ICU] and case-fatality rates [CFR]. Variables were controlled by age, sex and altitude of residence to calculate adjusted prevalence and prevalence ratios. Results Patients with DM had a 21.8% higher prevalence of COVID-19 and an additional 120.2% higher prevalence of COVID-19 pneumonia. The adjusted prevalence was also higher for these outcomes as well as for hospitalization, intubation and ICU admission. COVID-19 and pneumonia patients with DM had a 97.0% and 19.4% higher CFR, respectively. With increasing altitudes, the probability of being a confirmed COVID-19 case and the development of pneumonia decreased along CFR for patients with and without DM. However, COVID-19 patients with DM were more likely to require intubation when residing at high altitude. Conclusions The study suggests that patients with DM have a higher probability of being a confirmed COVID-19 case and developing pneumonia. Higher altitude had a protective relationship against SARS-CoV-2 infection; however, it may be associated with more severe cases in patients with and without DM. High altitude decreases CFR for all COVID-19 patients. Our work also shows that women are less affected than men regardless of altitude en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject COVID 19 en_US
dc.subject Pneumonia en_US
dc.subject Intubation en_US
dc.subject Medical risk factors en_US
dc.subject SARS CoV 2 en_US
dc.subject Diabetes mellitus en_US
dc.subject Hypoxia en_US
dc.subject Obesity en_US
dc.title Diabetes increases the risk of COVID-19 in an altitude dependent manner: An analysis of 1,280,806 Mexican patients en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0255144
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.19
dc.relation.issn 1932-6203


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