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糖尿病是新冠病毒疾病(COVID-19)进展和预后的一个风险因素。

Diabetes is a risk factor for the progression and prognosis of COVID-19.

作者信息

Guo Weina, Li Mingyue, Dong Yalan, Zhou Haifeng, Zhang Zili, Tian Chunxia, Qin Renjie, Wang Haijun, Shen Yin, Du Keye, Zhao Lei, Fan Heng, Luo Shanshan, Hu Desheng

机构信息

Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Diabetes Metab Res Rev. 2020 Oct;36(7):e3319. doi: 10.1002/dmrr.3319. Epub 2020 Apr 7.

Abstract

BACKGOUND

To figure out whether diabetes is a risk factor influencing the progression and prognosis of 2019 novel coronavirus disease (COVID-19).

METHODS

A total of 174 consecutive patients confirmed with COVID-19 were studied. Demographic data, medical history, symptoms and signs, laboratory findings, chest computed tomography (CT) as well the treatment measures were collected and analysed.

RESULTS

We found that COVID-19 patients without other comorbidities but with diabetes (n = 24) were at higher risk of severe pneumonia, release of tissue injury-related enzymes, excessive uncontrolled inflammation responses and hypercoagulable state associated with dysregulation of glucose metabolism. Furthermore, serum levels of inflammation-related biomarkers such as IL-6, C-reactive protein, serum ferritin and coagulation index, D-dimer, were significantly higher (P < .01) in diabetic patients compared with those without, suggesting that patients with diabetes are more susceptible to an inflammatory storm eventually leading to rapid deterioration of COVID-19.

CONCLUSIONS

Our data support the notion that diabetes should be considered as a risk factor for a rapid progression and bad prognosis of COVID-19. More intensive attention should be paid to patients with diabetes, in case of rapid deterioration.

摘要

背景

明确糖尿病是否为影响2019新型冠状病毒病(COVID-19)进展和预后的危险因素。

方法

对174例连续确诊的COVID-19患者进行研究。收集并分析人口统计学数据、病史、症状和体征、实验室检查结果、胸部计算机断层扫描(CT)以及治疗措施。

结果

我们发现,无其他合并症但患有糖尿病的COVID-19患者(n = 24)发生重症肺炎、组织损伤相关酶释放、过度失控的炎症反应以及与糖代谢失调相关的高凝状态的风险更高。此外,与非糖尿病患者相比,糖尿病患者血清中白细胞介素-6、C反应蛋白、血清铁蛋白等炎症相关生物标志物水平以及凝血指标D-二聚体显著更高(P < 0.01),提示糖尿病患者更易发生炎症风暴,最终导致COVID-19快速恶化。

结论

我们的数据支持糖尿病应被视为COVID-19快速进展和预后不良的危险因素这一观点。对于糖尿病患者应给予更密切关注,以防病情快速恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/554d/7228407/275a24a6334a/DMRR-36-0-g002.jpg

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