Tongji School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pharmacy and the Center of Information, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Diabetes Care. 2020 Jul;43(7):1399-1407. doi: 10.2337/dc20-0660. Epub 2020 May 14.
Diabetes is one of the most distinct comorbidities of COVID-19. Here, we describe the clinical characteristics of and outcomes in patients with diabetes in whom COVID-19 was confirmed or clinically diagnosed (with typical features on lung imaging and symptoms) and their association with glucose-lowering or blood pressure-lowering medications.
In this retrospective study involving 904 patients with COVID-19 (136 with diabetes, mostly type 2 diabetes), clinical and laboratory characteristics were collected and compared between the group with diabetes and the group without diabetes, and between groups taking different medications. Logistic regression was used to explore risk factors associated with mortality or poor prognosis.
The proportion of comorbid diabetes is similar between cases of confirmed and of clinically diagnosed COVID-19. Risk factors for higher mortality of patients with diabetes and COVID-19 were older age (adjusted odds ratio [aOR] 1.09 [95% CI 1.04, 1.15] per year increase; = 0.001) and elevated C-reactive protein (aOR 1.12 [95% CI 1.00, 1.24]; = 0.043). Insulin usage (aOR 3.58 [95% CI 1.37, 9.35]; = 0.009) was associated with poor prognosis. Clinical outcomes of those who use an ACE inhibitor (ACEI) or angiotensin II type-I receptor blocker (ARB) were comparable with those of patients who do not use ACEI/ARB among COVID-19 patients with diabetes and hypertension.
C-reactive protein may help to identify patients with diabetes who are at greater risk of dying during hospitalization. Older patients with diabetes were prone to death related to COVID-19. Attention needs to be paid to patients with diabetes and COVID-19 who use insulin. ACEI/ARB use showed no significant impact on patients with diabetes and hypertension who have COVID-19.
糖尿病是 COVID-19 最显著的合并症之一。在这里，我们描述了确诊或临床诊断为 COVID-19（肺部影像学表现和症状典型）的糖尿病患者的临床特征和转归，以及他们与降糖或降压药物的关系。
在这项涉及 904 例 COVID-19 患者（136 例合并糖尿病，主要为 2 型糖尿病）的回顾性研究中，收集了临床和实验室特征，并比较了糖尿病组和非糖尿病组、使用不同药物组之间的差异。采用 logistic 回归分析探讨与死亡率或预后不良相关的危险因素。
确诊 COVID-19 和临床诊断 COVID-19 患者中合并糖尿病的比例相似。糖尿病合并 COVID-19 患者死亡风险较高的危险因素为年龄较大（校正比值比[aOR]每增加 1 岁为 1.09[95%CI 1.04，1.15]； = 0.001）和 C 反应蛋白升高（aOR 1.12[95%CI 1.00，1.24]； = 0.043）。胰岛素使用（aOR 3.58[95%CI 1.37，9.35]； = 0.009）与预后不良相关。在糖尿病合并高血压的 COVID-19 患者中，使用 ACEI 或血管紧张素 II 型 1 型受体阻滞剂（ARB）与不使用 ACEI/ARB 的患者相比，临床结局相当。
C 反应蛋白可能有助于识别住院期间死亡风险较高的糖尿病患者。年龄较大的糖尿病患者易死于 COVID-19。需要关注使用胰岛素的糖尿病合并 COVID-19 患者。ACEI/ARB 的使用对 COVID-19 合并糖尿病和高血压的患者没有显著影响。
