353. New-Onset Diabetes as an Acute Complication of COVID-19: A National Population Cohort Analysis

Abstract Background Diabetes is emerging as one of the complications of coronavirus disease 2019 (COVID-19), but this is hard to be revealed with cross-sectional studies since it is also known as the major predisposing factor for high-risk COVID-19. Therefore, this study aimed to estimate the risk of new-onset diabetes after COVID-19 through a population follow-up study. Methods All COVID-19 confirmed cases in Korea from January 20 to June 4, 2020, were matched with national health insurance data and their health screening data, both provided by the National Health Insurance Service of Korea. Controls were selected as the people who received the PCR test for COVID-19 and showed negative results in the same period and followed up until July 19, 2020. We selected the outcome as the diagnosis of diabetes according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, E10 – E14). People who were diagnosed with diabetes in the past five years were excluded from both groups. After performing a log-rank test between groups, adjusted incidence rate and hazard ratio were estimated using Cox proportional hazard modeling. Demographic characteristics (age, sex, region, family histories of hypertension/diabetes, and income) and underlying health conditions such as hypertension, dyslipidemia, heart disease, alcohol consumption, cigarette smoking, and BMI were adjusted. Proportional assumptions were tested by the zph test and the sensitivity analysis by excluding each factor in turn and comparing results. Results A total of 6,247 COVID-19 patients and 143,594 controls without diabetes in the past were included for the analysis. The number of new-onset diabetes were 759 (12.15%) in COVID-19 patients and 3,465 (2.41%) in controls (P < 0.01). The adjusted incidence of diabetes was 15.34 (95% confidence interval, CI: 14.10 – 16.66) and 11.18 (95% CI: 10.67 – 11.72) per 100 person-year, respectively, with the mean follow-up time as 46.31 (standard deviation: 16.37) days. The adjusted hazard ratio of diabetes in COVID-19 cases was 2.97 (95% CI: 2.44 – 3.63). Conclusion Since COVID-19 patients showed a higher incidence of new-onset diabetes in a short-time follow-up, we should consider diabetes as one of the possible complications of COVID-19. Disclosures All Authors: No reported disclosures

. Patient characteristics and antibiotic management. Abbreviations: BAL -bronchoalveolar lavage Conclusion. Rapid, highly sensitive diagnostic tests have potential to guide clinical decisions and promote antibiotic stewardship among patients with severe viral pneumonia and suspected bacterial co-infection. In this descriptive analysis, antibiotic management did not differ significantly with use of PP. While most patients with detected organism on PP had targeted antibiotic changes, a negative PP did not appear to influence antibiotic narrowing. Larger studies and provider education are needed to evaluate potential of the PP for antibiotic stewardship.
Disclosures with restricted study subjects without control group. Therefore, our study aims to investigate the risk of developing alopecia areata (AA) among COVID-19 patients in South Korea using adequate control based on national representative data.
Methods. We used the National Health Insurance Service (NHIS) COVID-19 cohort database, comprising COVID-19 patient and control group, all of whom were diagnosed from January 1, 2020 to June 4, 2020. Patients were defined as individuals who were confirmed as COVID-19 positive, regardless of disease severity. Controls were defined as whom confirmed as COVID-19 negative. People with a history of AA during the period 2015-2019 were excluded. The primary endpoint was a new diagnosis of AA (ICD-10-CM-Code: L63). Adjusted incidence rate ratio (IRR) of developing AA was estimated using log-link Poisson regression model based on incidence density of case and control group. The model adjusted for (1) age and sex (2) demographic variables (age, sex, place of residence, and income level). Statistical significance was set at p< 0.05.
Results. A total of 226,737 individuals (7,958 [3.5%] cases and 218,779 [96.5%] controls) were included in the final analysis. There were more females than males, both in test positives and negatives at 59.9% and 52.3%, respectively. The largest test positive population was those in age group 20 to 29 years (25.5%),. The test negatives had the largest population in age group 30 to 39 years (17.1%). The ratio of newly diagnosed AA was 18/7,958 (0.2%) in cases and 195/218,779 (0.1%) in controls. IRRs of COVID-19 patients having newly diagnosed AA compared to controls were 0.78 (0.48-1.27) when age and sex were adjusted for, and 0.60 (0.35-1.03) when all demographic variables were adjusted for.
Flowchart of study subject selection Conclusion. Diagnosis of COVID-19 was not significantly associated with development of AA even after appropriately adjusting for covariates.

Session: P-14. COVID-19 Complications, Co-infections, and Clinical Outcomes
Background. Diabetes is emerging as one of the complications of coronavirus disease 2019 (COVID-19), but this is hard to be revealed with cross-sectional studies since it is also known as the major predisposing factor for high-risk COVID-19. Therefore, this study aimed to estimate the risk of new-onset diabetes after COVID-19 through a population follow-up study.
Methods. All COVID-19 confirmed cases in Korea from January 20 to June 4, 2020, were matched with national health insurance data and their health screening data, both provided by the National Health Insurance Service of Korea. Controls were selected as the people who received the PCR test for COVID-19 and showed negative results in the same period and followed up until July 19, 2020. We selected the outcome as the diagnosis of diabetes according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, E10 -E14). People who were diagnosed with diabetes in the past five years were excluded from both groups. After performing a log-rank test between groups, adjusted incidence rate and hazard ratio were estimated using Cox proportional hazard modeling. Demographic characteristics (age, sex, region, family histories of hypertension/diabetes, and income) and underlying health conditions such as hypertension, dyslipidemia, heart disease, alcohol consumption, cigarette smoking, and BMI were adjusted. Proportional assumptions were tested by the zph test and the sensitivity analysis by excluding each factor in turn and comparing results.
Results. A total of 6,247 COVID-19 patients and 143,594 controls without diabetes in the past were included for the analysis. The number of new-onset diabetes were 759 (12.15%) in COVID-19 patients and 3,465 (2.41%) in controls (P < 0.01). The