Umberto I "Policlinico" General Hospital, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
Diabetes Trial Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Cardiovasc Diabetol. 2020 Oct 1;19(1):164. doi: 10.1186/s12933-020-01140-2.
Cardiometabolic disorders may worsen Covid-19 outcomes. We investigated features and Covid-19 outcomes for patients with or without diabetes, and with or without cardiometabolic multimorbidity.
We collected and compared data retrospectively from patients hospitalized for Covid-19 with and without diabetes, and with and without cardiometabolic multimorbidity (defined as ≥ two of three risk factors of diabetes, hypertension or dyslipidaemia). Multivariate logistic regression was used to assess the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit [ICU] or death) in patients with diabetes and in those with cardiometabolic multimorbidity, adjusting for confounders.
Of 354 patients enrolled, those with diabetes (n = 81), compared with those without diabetes (n = 273), had characteristics associated with the primary composite outcome that included older age, higher prevalence of hypertension and chronic obstructive pulmonary disease (COPD), higher levels of inflammatory markers and a lower PaO2/FIO2 ratio. The risk of the primary composite outcome in the 277 patients who completed the study as of May 15, 2020, was higher in those with diabetes (Adjusted Odds Ratio (OR) 2.04, 95%CI 1.12-3.73, p = 0.020), hypertension (OR 2.31, 95%CI: 1.37-3.92, p = 0.002) and COPD (OR 2.67, 95%CI 1.23-5.80, p = 0.013). Patients with cardiometabolic multimorbidity were at higher risk compared to patients with no cardiometabolic conditions (OR 3.19 95%CI 1.61-6.34, p = 0.001). The risk for patients with a single cardiometabolic risk factor did not differ with that for patients with no cardiometabolic risk factors (OR 1.66, 0.90-3.06, p = 0.10).
Patients with diabetes hospitalized for Covid-19 present with high-risk features. They are at increased risk of adverse outcomes, likely because diabetes clusters with other cardiometabolic conditions.
心脏代谢疾病可能会使 COVID-19 患者的预后恶化。我们研究了患有或不患有糖尿病、以及患有或不患有心脏代谢合并症的 COVID-19 患者的特征和 COVID-19 结局。
我们回顾性地收集并比较了因 COVID-19 住院的患者的数据，这些患者患有或不患有糖尿病，以及患有或不患有心脏代谢合并症（定义为≥两种糖尿病、高血压或血脂异常的风险因素之一）。使用多变量逻辑回归来评估患有糖尿病和患有心脏代谢合并症的患者发生主要复合结局（任何机械通气、入住重症监护病房[ICU]或死亡）的风险，同时调整混杂因素。
在纳入的 354 名患者中，患有糖尿病的患者（n=81）与不患有糖尿病的患者（n=273）相比，具有与主要复合结局相关的特征，包括年龄较大、高血压和慢性阻塞性肺疾病（COPD）的患病率较高、炎症标志物水平较高以及 PaO2/FIO2 比值较低。截至 2020 年 5 月 15 日完成研究的 277 名患者中，主要复合结局的风险在患有糖尿病的患者中更高（调整后的优势比（OR）2.04，95%CI 1.12-3.73，p=0.020）、患有高血压（OR 2.31，95%CI：1.37-3.92，p=0.002）和 COPD（OR 2.67，95%CI 1.23-5.80，p=0.013）的患者中更高。与没有心脏代谢疾病的患者相比，患有心脏代谢合并症的患者风险更高（OR 3.19，95%CI 1.61-6.34，p=0.001）。患有单一心脏代谢危险因素的患者的风险与没有心脏代谢危险因素的患者的风险没有差异（OR 1.66，95%CI 0.90-3.06，p=0.10）。
因 COVID-19 住院的糖尿病患者具有高危特征。他们发生不良结局的风险增加，这可能是因为糖尿病与其他心脏代谢疾病合并存在。
