Sachdeva Sonali, Desai Rupak, Gupta Udita, Prakash Anupam, Jain Abhinav, Aggarwal Ankita
Department of Anesthesiology and Critical Care Medicine, Maulana Azad Medical College, New Delhi, India.
Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd, Decatur, GA USA.
SN Compr Clin Med. 2020;2(11):2161-2166. doi: 10.1007/s42399-020-00575-8. Epub 2020 Oct 12.
In the latter part of 2019, a cluster of unexplained pneumonia cases were reported in Wuhan, China. In less than a year, SARS-CoV-2 has infected over 27 million people and claimed more than 800,000 deaths worldwide. Diabetes is a highly prevalent chronic metabolic disease, and recent reports have suggested a possible existence of COVID-19 related new-onset diabetes. Hyperglycemia induces an inflammatory state in the body, which coupled with coronavirus associated immune response is a possible explanation for clinical worsening of patients. We present a summary and pooled analysis of available evidence to ascertain the relationship between hyperglycemia in undiagnosed diabetics and outcomes of COVID-19 disease. Our results showed that hyperglycemia in non-diabetics was associated with higher risk of severe/critical illness (OR 1.837 (95% CI 1.368-2.465, < 0.001) and mortality (2.822, 95% CI 1.587-5.019, < 0.001) compared with those with normal values of blood glucose. The management of hyperglycemia in COVID-19 poses significant challenges in clinical practice, and the need to develop strategies for optimal glucose control in these patients cannot be overlooked.
2019年下半年，中国武汉报告了一批不明原因的肺炎病例。在不到一年的时间里，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已感染全球超过2700万人，并导致80多万人死亡。糖尿病是一种高度流行的慢性代谢疾病，最近的报告表明可能存在与2019冠状病毒病（COVID-19）相关的新发糖尿病。高血糖会在体内诱发炎症状态，再加上冠状病毒相关的免疫反应，这可能是患者临床病情恶化的一个原因。我们对现有证据进行了总结和汇总分析，以确定未确诊糖尿病患者的高血糖与COVID-19疾病预后之间的关系。我们的结果显示，与血糖值正常的患者相比，非糖尿病患者的高血糖与严重/危重症风险较高（比值比1.837（95%置信区间1.368-2.465，P<0.001））及死亡率较高（2.822，95%置信区间1.587-5.019，P<0.001）相关。在临床实践中，COVID-19患者的高血糖管理面临重大挑战，因此制定针对这些患者的最佳血糖控制策略的必要性不容忽视。
