Department of Medicine, Einstein Medical Center Philadelphia, 5501 Old York Road, Philadelphia, PA, 19141, USA.
Department of Endocrinology, Einstein Medical Center Philadelphia, Philadelphia, USA.
Acta Diabetol. 2021 Jan;58(1):33-38. doi: 10.1007/s00592-020-01592-8. Epub 2020 Aug 17.
Coronavirus disease 19 (COVID-19) has become a pandemic. Diabetic patients tend to have poorer outcomes and more severe disease (Kumar et al. in Diabetes Metab Syndr 14(4):535-545, 2020. https://doi.org/10.1016/j.dsx.2020.04.044 ). However, the vast majority of studies are representative of Asian and Caucasian population and fewer represent an African-American population.
In this single-center, retrospective observational study, we included all adult patients (> 18 years old) admitted to Einstein Medical Center, Philadelphia, with a diagnosis of COVID-19. Patients were classified according to having a known diagnosis of diabetes mellitus. Demographic and clinical data, comorbidities, outcomes and laboratory findings were obtained.
Our sample included a total of 355 patients. 70% were African-American, and 47% had diabetes. Patients with diabetes had higher peak inflammatory markers like CRP 184 (111-258) versus 142 (65-229) p = 0.012 and peak LDH 560 (384-758) versus 499 (324-655) p = 0.017. The need for RRT/HD was significantly higher in patients with diabetes (21% vs 11% p = 0.013) as well as the need for vasopressors (28% vs 18% p = 0.023). Only age was found to be an independent predictor of mortality. We found no significant differences in inpatient mortality p = 0.856, need for RRT/HD p = 0.429, need for intubation p = 1.000 and need for vasopressors p = 0.471 in African-Americans with diabetes when compared to non-African-Americans.
Our study demonstrates that patients with COVID-19 and diabetes tend to have more severe disease and poorer clinical outcomes. African-American patients with diabetes did not differ in outcomes or disease severity when compared to non-African-American patients.
新冠肺炎（COVID-19）已成为一种全球性疾病。糖尿病患者往往预后较差，疾病更为严重（Kumar 等人在《糖尿病代谢综合征》14(4):535-545，2020 年。https://doi.org/10.1016/j.dsx.2020.04.044）。然而，绝大多数研究都代表了亚洲和白种人群体，而代表非裔美国人的研究较少。
在这项单中心、回顾性观察性研究中，我们纳入了所有因 COVID-19 而被收入费城爱因斯坦医疗中心的成年患者（>18 岁）。根据是否患有糖尿病的明确诊断对患者进行分类。获取人口统计学和临床数据、合并症、结局和实验室检查结果。
我们的样本共包括 355 名患者。70%为非裔美国人，47%患有糖尿病。患有糖尿病的患者炎症标志物峰值更高，如 CRP 为 184（111-258），而 CRP 为 142（65-229）（p=0.012），LDH 峰值为 560（384-758），而 LDH 为 499（324-655）（p=0.017）。患有糖尿病的患者需要肾脏替代治疗/血液透析（RRT/HD）的比例明显更高（21% vs 11%，p=0.013），需要血管加压素的比例也更高（28% vs 18%，p=0.023）。仅年龄被发现是死亡率的独立预测因素。我们发现非裔美国人糖尿病患者与非非裔美国人相比，住院死亡率（p=0.856）、需要 RRT/HD（p=0.429）、需要插管（p=1.000）和需要血管加压素（p=0.471）无显著差异。
我们的研究表明，患有 COVID-19 和糖尿病的患者往往病情更严重，临床结局更差。与非非裔美国人相比，非裔美国人糖尿病患者的结局或疾病严重程度无差异。
