Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan 410008, China.
Diabetes Res Clin Pract. 2020 Jul;165:108227. doi: 10.1016/j.diabres.2020.108227. Epub 2020 May 22.
The 2019 novel coronavirus disease (COVID-19) emerged in Wuhan, China, and was characterized as a pandemic by the World Health Organization. Diabetes is an established risk associated with poor clinical outcomes, but the association of diabetes with COVID-19 has not been reported yet.
In this cohort study, we retrospectively reviewed 258 consecutive hospitalized COVID-19 patients with or without diabetes at the West Court of Union Hospital in Wuhan, China, recruited from January 29 to February 12, 2020. The clinical features, treatment strategies and prognosis data were collected and analyzed. Prognosis was followed up until March 12, 2020.
Of the 258 hospitalized patients (63 with diabetes) with COVID-19, the median age was 64 years (range 23-91), and 138 (53.5%) were male. Common symptoms included fever (82.2%), dry cough (67.1%), polypnea (48.1%), and fatigue (38%). Patients with diabetes had significantly higher leucocyte and neutrophil counts, and higher levels of fasting blood glucose, serum creatinine, urea nitrogen and creatine kinase isoenzyme MB at admission compared with those without diabetes. COVID-19 patients with diabetes were more likely to develop severe or critical disease conditions with more complications, and had higher incidence rates of antibiotic therapy, non-invasive and invasive mechanical ventilation, and death (11.1% vs. 4.1%). Cox proportional hazard model showed that diabetes (adjusted hazard ratio [aHR] = 3.64; 95% confidence interval [CI]: 1.09, 12.21) and fasting blood glucose (aHR = 1.19; 95% CI: 1.08, 1.31) were associated with the fatality due to COVID-19, adjusting for potential confounders.
Diabetes mellitus is associated with increased disease severity and a higher risk of mortality in patients with COVID-19.
2019 年新型冠状病毒病（COVID-19）在中国武汉出现，并被世界卫生组织（WHO）定性为大流行。糖尿病是与不良临床结局相关的既定风险因素，但糖尿病与 COVID-19 的关联尚未见报道。
在这项回顾性队列研究中，我们对 2020 年 1 月 29 日至 2 月 12 日期间在中国武汉协和医院西区连续收治的 258 例 COVID-19 住院患者（合并或不合并糖尿病）进行了回顾性研究。收集并分析了临床特征、治疗策略和预后数据。预后随访至 2020 年 3 月 12 日。
258 例 COVID-19 住院患者（合并糖尿病 63 例）的中位年龄为 64 岁（范围为 23-91 岁），138 例（53.5%）为男性。常见症状包括发热（82.2%）、干咳（67.1%）、呼吸急促（48.1%）和乏力（38%）。与无糖尿病患者相比，糖尿病患者入院时白细胞和中性粒细胞计数更高，空腹血糖、血清肌酐、尿素氮和肌酸激酶同工酶 MB 水平更高。COVID-19 合并糖尿病患者更易发展为重症或危重症，并发症更多，抗生素治疗、无创和有创机械通气以及死亡发生率更高（11.1% vs. 4.1%）。Cox 比例风险模型显示，糖尿病（调整后危险比[aHR] = 3.64；95%置信区间[CI]：1.09，12.21）和空腹血糖（aHR = 1.19；95% CI：1.08，1.31）与 COVID-19 死亡相关，调整了潜在混杂因素。
糖尿病与 COVID-19 患者疾病严重程度增加和死亡率升高相关。
