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住院的 COVID-19 患者中合并与不合并糖尿病患者的特征和结局。

Characteristics and outcomes of COVID-19 in hospitalized patients with and without diabetes.

机构信息

Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France.

PériTox = UMR_I 01, University of Picardy Jules Verne, Amiens, France.

出版信息

Diabetes Metab Res Rev. 2021 Mar;37(3):e3388. doi: 10.1002/dmrr.3388. Epub 2020 Aug 18.


DOI:10.1002/dmrr.3388
PMID:32683744
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7404605/
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a rapidly progressing pandemic, with four million confirmed cases and 280 000 deaths at the time of writing. Some studies have suggested that diabetes is associated with a greater risk of developing severe forms of COVID-19. The primary objective of the present study was to compare the clinical features and outcomes in hospitalized COVID-19 patients with vs without diabetes. METHODS: All consecutive adult patients admitted to Amiens University Hospital (Amiens, France) with confirmed COVID-19 up until April 21st, 2020, were included. The composite primary endpoint comprised admission to the intensive care unit (ICU) and death. Both components were also analysed separately in a logistic regression analysis and a Cox proportional hazards model. RESULTS: A total of 433 patients (median age: 72; 238 (55%) men; diabetes: 115 (26.6%)) were included. Most of the deaths occurred in non-ICU units and among older adults. Multivariate analyses showed that diabetes was associated neither with the primary endpoint (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.66-1.90) nor with mortality (hazard ratio: 0.73; 95%CI: 0.40-1.34) but was associated with ICU admission (OR: 2.06; 95%CI 1.09-3.92, P = .027) and a longer length of hospital stay. Age was negatively associated with ICU admission and positively associated with death. CONCLUSIONS: Diabetes was prevalent in a quarter of the patients hospitalized with COVID-19; it was associated with a greater risk of ICU admission but not with a significant elevation in mortality. Further investigation of the relationship between COVID-19 severity and diabetes is warranted.

摘要

背景:2019 年冠状病毒病(COVID-19)是一种迅速发展的大流行疾病,截至撰写本文时,已有 400 万例确诊病例和 28 万例死亡。一些研究表明,糖尿病与发生 COVID-19 严重形式的风险增加有关。本研究的主要目的是比较住院 COVID-19 患者中伴有和不伴有糖尿病的临床特征和结局。

方法:所有连续入住法国亚眠大学医院(Amiens,法国)并确诊 COVID-19 的成年患者均纳入本研究,直至 2020 年 4 月 21 日。主要复合终点包括入住重症监护病房(ICU)和死亡。在 logistic 回归分析和 Cox 比例风险模型中,分别对两个组成部分进行了单独分析。

结果:共纳入 433 例患者(中位年龄:72 岁;238 例[55%]男性;糖尿病:115 例[26.6%])。大多数死亡发生在非 ICU 病房和老年患者中。多变量分析显示,糖尿病与主要终点(比值比(OR):1.12;95%置信区间(CI):0.66-1.90)或死亡率(风险比:0.73;95%CI:0.40-1.34)均无相关性,但与 ICU 入院(OR:2.06;95%CI 1.09-3.92,P = 0.027)和住院时间延长相关。年龄与 ICU 入院呈负相关,与死亡呈正相关。

结论:COVID-19 住院患者中有四分之一患有糖尿病;它与 ICU 入院风险增加相关,但与死亡率显著升高无关。需要进一步研究 COVID-19 严重程度与糖尿病之间的关系。

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本文引用的文献

[1]
Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation.

Diabetes Metab Res Rev. 2021-1

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Metabolism. 2020-5-16

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MMWR Morb Mortal Wkly Rep. 2020-4-17

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Endocr Rev. 2020-6-1

[10]
High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation.

Obesity (Silver Spring). 2020-6-10

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