Huang Juan, Zhu Lin, Bai Xiangli, Jia Xiong, Lu Yajing, Deng Aiping, Li Juyi, Jin Si
Department of Endocrinology, Institute of Geriatric Medicine, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, Hubei, China.
Department of Personnel, Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430077, Hubei, China.
Infect Dis Ther. 2020 Dec;9(4):981-1002. doi: 10.1007/s40121-020-00359-6. Epub 2020 Oct 28.
Diabetes is one of the most common comorbidities of COVID-19. We aimed to conduct a multidimensional analysis of risk factors associated with the severity and mortality of patients with COVID-19 and diabetes.
In this retrospective study involving 1443 patients with COVID-19, we analyzed the clinical and laboratory characteristics and risk factors associated with disease severity in patients with COVID-19 with and without diabetes. Binary logistic regression analyses were performed to identify the risk factors associated with mortality in patients with COVID-19 and diabetes. The 84-day survival duration for critical patients with COVID-19 and diabetes who had different levels of leukocytes and neutrophils, or treated with immunoglobulin or not, was conducted using Kaplan-Meier survival curves.
Of the 1443 patients with COVID-19, 256 (17.7%) had diabetes, had a median age of 66.0 [IQR 58.0-73.8] years, and were more likely to develop severe (41.8% vs. 35.6%) and critical disease (34.0% vs. 14.9%), followed by higher mortality (21.1% vs. 7.0%), than those without diabetes. Higher levels of leukocytes (> 5.37 × 10/L), older age, and comorbid cerebrovascular disease and chronic renal disease independently contributed to in-hospital death of patients with COVID-19 and diabetes. Leukocytes > 5.37 × 10/L and the application of immunoglobulin were associated with shorter survival duration and lower mortality, respectively, in critical patients with COVID-19 and diabetes.
More attention should be paid to patients with COVID-19 and diabetes, especially when they have high leukocyte counts (> 5.37 × 10/L). Timely and adequate intravenous immunoglobulin (IVIG) use may reduce the mortality of critical patients with COVID-19 and diabetes.
糖尿病是新型冠状病毒肺炎（COVID-19）最常见的合并症之一。我们旨在对与COVID-19合并糖尿病患者的严重程度和死亡率相关的危险因素进行多维度分析。
在这项涉及1443例COVID-19患者的回顾性研究中，我们分析了合并或未合并糖尿病的COVID-19患者的临床和实验室特征以及与疾病严重程度相关的危险因素。进行二元逻辑回归分析以确定与COVID-19合并糖尿病患者死亡率相关的危险因素。使用Kaplan-Meier生存曲线对COVID-19合并糖尿病的重症患者在白细胞和中性粒细胞水平不同或接受免疫球蛋白治疗与否的情况下的84天生存时间进行了分析。
在1443例COVID-19患者中，256例（17.7%）患有糖尿病，中位年龄为66.0岁[四分位间距58.0 - 73.8岁]，与未患糖尿病的患者相比，他们更易发展为重症（41.8%对35.6%）和危重症（34.0%对14.9%），随后死亡率更高（21.1%对7.0%）。白细胞水平较高（＞5.37×10⁹/L）、年龄较大以及合并脑血管疾病和慢性肾病独立导致了COVID-19合并糖尿病患者的院内死亡。白细胞＞5.37×10⁹/L和应用免疫球蛋白分别与COVID-19合并糖尿病的重症患者较短的生存时间和较低的死亡率相关。
应更加关注COVID-19合并糖尿病的患者，尤其是当他们白细胞计数较高（＞5.37×10⁹/L）时。及时且充分地使用静脉注射免疫球蛋白（IVIG）可能会降低COVID-19合并糖尿病重症患者的死亡率。
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