Researchers recently published a study in Communications Biology exploring the impact of type 2 diabetes and genetic susceptibility for the disease on the severity and mortality risk associated with Coronavirus Disease 2019 (COVID-19), using data from the UK Biobank.
The COVID-19 pandemic continues, albeit in a less virulent form, with new variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), despite widespread vaccinations worldwide.
It has been noted that SARS-CoV-2 infections manifest in a variety of symptoms, ranging from asymptomatic to severe cases with acute respiratory distress, pneumonia, and death.
A significant number of COVID-19 cases also transition to a post-acute COVID-19 syndrome, commonly known as long COVID.
Extensive research also suggests 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.
Furthermore, genome-wide association studies have indicated that genetic variants associated with increased risk of cardiovascular disease, type 2 diabetes, lung disease, and those involved in immune mechanisms are linked to a higher risk of severe SARS-CoV-2 infections.
Über die Studie
The study utilized UK Biobank data to investigate whether type 2 diabetes and polygenic risk scores for type 2 diabetes are associated with increased severity of SARS-CoV-2 infections and higher COVID-19 mortality rates.
They also examined the impact of vaccinations on this association and evaluated the effects of numerous SARS-CoV-2 variants, including the recently emerged Omicron variants.
The polygenic risk scores for type 2 diabetes from the UK Biobank’s genome-wide association summary statistics were initially used to determine genetic predisposition for type 2 diabetes.
To account for the confounding influence of body mass index (BMI) on type 2 diabetes, the researchers included BMI as a covariate in the computation of the polygenic risk scores for type 2 diabetes in the genome-wide association study.
Subsequently, they determined using proportional odds models whether type 2 diabetes and genetic predisposition for type 2 diabetes are associated with increased severity of SARS-CoV-2 infections.
They also investigated how type 2 diabetes or genetic risk for type 2 diabetes impacted survival time when the person was infected with SARS-CoV-2.
Furthermore, they re-evaluated the influence on survival time with respect to vaccination status and for a variety of SARS-CoV-2 variants.
They also examined whether mortality rates significantly differed among three groups – COVID-19, type 2 diabetes, and genetic predisposition for type 2 diabetes – using a stratified survival analysis.
The results showed an association between type 2 diabetes, polygenic risk scores for type 2 diabetes, and increased severity of COVID-19. The mortality rate was also higher for individuals with type 2 diabetes or a genetic predisposition.
Based on the timing of infection, the mortality rate among patients with type 2 diabetes infected with SARS-CoV-2 was two to seven times higher compared to patients without SARS-CoV-2 infection.
It was also found that the mortality rate was higher for the earlier SARS-CoV-2 variants, with the mortality risk decreasing for the Alpha, EU1, and Delta variants compared to the Omicron variants.
Additionally, vaccinated patients with type 2 diabetes had a significantly lower risk of severe SARS-CoV-2 infections compared to those who were not vaccinated.
The association between polygenic risk scores for type 2 diabetes and increased risk of severe COVID-19 suggests an interplay between the genetic factors underlying type 2 diabetes and COVID-19, offering potential research opportunities to understand the newly associated genetic factors contributing to severe SARS-CoV-2 infections.
In summary, the study examined the association between type 2 diabetes or polygenic risk scores for type 2 diabetes and the likelihood of developing severe COVID-19.
The results suggest that individuals with either a genetic predisposition for type 2 diabetes or those with the disease have an increased risk of severe SARS-CoV-2 infections and higher mortality due to COVID-19. However, COVID-19 vaccinations reduce the risk of severe COVID-19 and mortality in these groups.
Lee, A., Seo, J., Park, S., Cho, Y., Kim, G., Li, J., Liang, L., Park, T. & Chung, W. (2024). Typ-2-Diabetes und seine genetische Anfälligkeit werden laut UK Biobank mit einer erhöhten Schwere und Mortalität von COVID-19 in Verbindung gebracht. Kommunikationsbiologie, 7(1), 122. doi: https://doi.org/10.1038/s42003024057991. https://www.nature.com/articles/s42003-024-05799-1