The disproportionate excess mortality risk of COVID-19 in younger people with diabetes warrants vaccination prioritisation – published online 16/02/2021

Andrew P. McGovern, Nick J. Thomas, Sebastian J. Vollmer, Andrew T. Hattersley, Bilal A. Mateen, John M. Dennis

In this issue, McGovern et al (https://doi.org/10.1007/s00125-021-05404-8) investigate the combined effects of age and diabetes on Coronavirus disease-2019 (COVID-19) mortality. Triangulating published data from large UK population-based (OpenSAFELY [n=17,278,392] and QCOVID [n=6,083,102]) and critical care-based (COVID-19 Hospitalisation in England Surveillance System [CHESS] cohort [n=19,256]) studies, the authors describe a disproportionate excess relative mortality risk in younger people with diabetes compared with older people with diabetes. For example, a person aged 40 years with diabetes has the equivalent COVID-19 mortality risk of a 60-year-old person without diabetes: an additional risk of 20 years. This difference reduces significantly with increasing age, so that a person aged 70 with diabetes has the equivalent COVID-19 mortality risk of a 78-year-old person without diabetes: an additional risk of just 8 years. The authors suggest that country-level strategies to define priority groups for vaccination should consider the disproportionate relative risk of COVID-19 mortality in middle-aged people with diabetes.

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