Department of Pancreatic Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
Diabetes Care. 2020 Jul;43(7):1382-1391. doi: 10.2337/dc20-0598. Epub 2020 May 14.
Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes.
This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes ( = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients.
Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, = 0.01) and more fatal cases (20.3% vs. 10.5%, = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all values <0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes.
COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.
糖尿病在 COVID-19 患者中较为常见，且与不良结局相关。本研究旨在描述 COVID-19 合并糖尿病患者的特征和结局，并分析其院内死亡的危险因素。
这是一项在中国武汉两家三级医院进行的回顾性、双中心研究。纳入 2020 年 1 月 1 日至 2020 年 3 月 8 日出院或死亡的 COVID-19 合并糖尿病患者（n=153），并为每位患者匹配 1 名性别和年龄相匹配的无糖尿病 COVID-19 患者。提取患者的人口统计学、临床和实验室数据。采用 Cox 比例风险回归分析确定与这些患者死亡相关的危险因素。
在 1561 例 COVID-19 患者中，153 例（9.8%）患有糖尿病，中位年龄为 64.0（四分位间距 56.0-72.0）岁。与匹配患者相比，COVID-19 合并糖尿病患者更易入住重症监护病房（17.6% vs. 7.8%，=0.01），且死亡例数更多（20.3% vs. 10.5%，=0.017）。对这 306 例患者进行多变量 Cox 回归分析显示，高血压（危险比[HR]2.50，95%可信区间[CI]1.30-4.78）、心血管疾病（HR 2.24，95%CI 1.19-4.23）和慢性肺部疾病（HR 2.51，95%CI 1.07-5.90）与院内死亡独立相关。糖尿病（HR 1.58，95%CI 0.84-2.99）在调整后与院内死亡无统计学显著相关性。在糖尿病患者中，死亡患者年龄更大（76.0 vs. 63.0 岁），大多数为男性（71.0% vs. 29.0%），且更易合并高血压（83.9% vs. 50.0%）和心血管疾病（45.2% vs. 14.8%）（所有 P 值均<0.05）。年龄≥70 岁（HR 2.39，95%CI 1.03-5.56）和高血压（HR 3.10，95%CI 1.14-8.44）是糖尿病患者院内死亡的独立危险因素。
与性别和年龄匹配的无糖尿病 COVID-19 患者相比，COVID-19 合并糖尿病患者的结局更差。年龄较大和合并高血压是糖尿病患者院内死亡的独立危险因素。
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