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新冠肺炎合并血糖控制良好与控制不佳的患者:其结局和影像学表现是否存在差异?

Well-controlled vs poorly-controlled diabetes in patients with COVID-19: Are there any differences in outcomes and imaging findings?

机构信息

Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Diabetes Res Clin Pract. 2020 Aug;166:108286. doi: 10.1016/j.diabres.2020.108286. Epub 2020 Jun 25.

Abstract

AIMS

We aimed to compare the clinical outcomes and imaging findings between COVID-19 patients with well-controlled diabetes and those with poorly-controlled diabetes.

METHODS

In this retrospective single-center study, 117 patients with coexistent COVID-19 and type 2 diabetes mellitus were included. Patients were divided into two groups based on HbA1c values. Clinical data and laboratory parameters were collected from patients' medical records. Also, the chest computed tomography (CT) score was defined by the summation of individual scores from 5 lung lobes: scores of 0, 1, 2, 3, 4 and 5 were respectively assigned for each lobe if pulmonary involvement was 0%, less than 5%, 5%-25%, 26%-49%, 50%-75%, or more than 75% of each region.

RESULTS

Among all patients with diabetes, 93 (79.5%) patients had poorly-controlled diabetes and 24 (20.5%) had well-controlled diabetes; 66 (56.4%) patients were male and the median age was 66 years (IQR, 55-75 years). The chest CT severity scores were not significantly different between patients with well-controlled diabetes and those with poorly-controlled diabetes (p = 0.33). Also, the mortality and recovery rates were similar between the two groups (p = 0.54 and p = 0.85, respectively).

CONCLUSION

Based on the results, clinical outcomes and chest CT severity scores are similar between patients with well-controlled and poorly-controlled diabetes among the Iranian population with COVID-19.

摘要

目的

我们旨在比较 COVID-19 合并糖尿病患者中血糖控制良好与控制不佳者的临床结局和影像学表现。

方法

在这项回顾性单中心研究中,纳入了 117 例合并 COVID-19 和 2 型糖尿病的患者。根据 HbA1c 值将患者分为两组。从患者病历中收集临床数据和实验室参数。同时,通过对 5 个肺叶的个体评分进行求和来定义胸部计算机断层扫描(CT)评分:如果肺部受累程度分别为 0%、<5%、5%-25%、26%-49%、50%-75%和>75%,则每个肺叶分别记为 0、1、2、3 和 4 分。

结果

在所有糖尿病患者中,93 例(79.5%)血糖控制不佳,24 例(20.5%)血糖控制良好;66 例(56.4%)为男性,中位年龄为 66 岁(IQR,55-75 岁)。血糖控制良好的患者与血糖控制不佳的患者之间,胸部 CT 严重程度评分无显著差异(p=0.33)。此外,两组的死亡率和恢复率相似(p=0.54 和 p=0.85)。

结论

基于研究结果,伊朗 COVID-19 人群中血糖控制良好与控制不佳的患者之间的临床结局和胸部 CT 严重程度评分相似。

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Chest CT Severity Score: An Imaging Tool for Assessing Severe COVID-19.胸部CT严重程度评分:一种评估重症COVID-19的影像学工具。
Radiol Cardiothorac Imaging. 2020 Mar 30;2(2):e200047. doi: 10.1148/ryct.2020200047. eCollection 2020 Apr.
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Prevalence and impact of diabetes among people infected with SARS-CoV-2.2019冠状病毒病感染者中糖尿病的患病率及影响
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