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糖尿病对严重急性呼吸综合征冠状病毒 2 型(COVID-19)感染的严重程度和病死率的影响。

Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection.

机构信息

Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Soochow, China.

Soochow University Hosiptal, Soochow University, Soochow, China.

出版信息

Diabetes Obes Metab. 2020 Oct;22(10):1907-1914. doi: 10.1111/dom.14105. Epub 2020 Jul 7.

Abstract

AIM

To evaluate the influence of diabetes on the severity and fatality of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

MATERIALS AND METHODS

The medical records of 66 hospitalized coronavirus disease 2019 (COVID-19) patients were collected and classified into non-severe (mild/moderate cases) and severe (severe/critical cases) groups. Logistic regression analysis was used to estimate the risk of severe COVID-19 (severe/critical infection). In addition, a meta-analysis including published studies reported the impact of diabetes on the severity and fatality of COVID-19. The current study was conducted using fixed effects models.

RESULTS

There were 22 diabetes and 44 non-diabetes cases among the 66 hospitalized COVID-19 patients. Seven patients with diabetes (31.82%) were diagnosed as severe COVID-19 cases, which was significantly higher than that in the non-diabetes group (4/44, 9.09%, P = .033). After adjustment for age and gender, diabetes was significantly associated with COVID-19 severity (OR: 5.29, 95% CI: 1.07-26.02). A meta-analysis further confirmed the positive association between diabetes and COVID-19 severity (pooled OR = 2.58, 95% CI: 1.93-3.45). Moreover, the patients with diabetes infected with SARS-CoV-2 had a 2.95-fold higher risk of fatality compared with those patients without diabetes (95% CI: 1.93-4.53).

CONCLUSIONS

Our findings provide new evidence that diabetes is associated with a higher risk of severity and fatality of COVID-19. Therefore, intensive monitoring and antidiabetic therapy should be considered in patients with diabetes with SARS-CoV-2 infection.

摘要

目的

评估糖尿病对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染严重程度和病死率的影响。

材料和方法

收集了 66 例住院的 2019 冠状病毒病(COVID-19)患者的病历,并将其分为非重症(轻症/中度病例)和重症(重症/危重症病例)组。采用 logistic 回归分析估计重症 COVID-19(重症/危重症感染)的风险。此外,还进行了一项荟萃分析,纳入了已发表的研究报告,以评估糖尿病对 COVID-19 严重程度和病死率的影响。本研究采用固定效应模型进行。

结果

在 66 例住院 COVID-19 患者中,有 22 例患有糖尿病,44 例无糖尿病。在糖尿病患者中,有 7 例(31.82%)被诊断为重症 COVID-19 病例,明显高于非糖尿病组(4/44,9.09%,P=0.033)。在校正年龄和性别后,糖尿病与 COVID-19 严重程度显著相关(OR:5.29,95%CI:1.07-26.02)。荟萃分析进一步证实了糖尿病与 COVID-19 严重程度之间的正相关关系(汇总 OR=2.58,95%CI:1.93-3.45)。此外,与无糖尿病的患者相比,感染 SARS-CoV-2 的糖尿病患者的病死率风险增加了 2.95 倍(95%CI:1.93-4.53)。

结论

我们的研究结果提供了新的证据,表明糖尿病与 COVID-19 的严重程度和病死率风险增加有关。因此,对于感染 SARS-CoV-2 的糖尿病患者,应进行强化监测和抗糖尿病治疗。

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