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沙特阿拉伯利雅得一家专门的三级医院收治的成年 COVID-19 患者的糖尿病患病率、管理和结局。

Prevalence of diabetes, management and outcomes among Covid-19 adult patients admitted in a specialized tertiary hospital in Riyadh, Saudi Arabia.

机构信息

Diabetes Care Center, King Salman Bin Abdulaziz Hospital, Riyadh 12769, Saudi Arabia.

Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.

出版信息

Diabetes Res Clin Pract. 2021 Feb;172:108538. doi: 10.1016/j.diabres.2020.108538. Epub 2020 Nov 13.

Abstract

This retrospective study aimed to characterize comorbidities and associated with mortality among hospitalized adults with Covid-19 managed as perthe Saudi Ministry of Health protocol in a specialized tertiary hospital in Riyadh, Saudi Arabia. Medical records of 300 adult patients with PCR-confirmed SARS-CoV2 infection and admitted in King Salman Hospital (KSH) from May 1 to July 31, 2020 were included. Medical history, management and outcomes were noted. Males significantly outnumber females (259 versus 41). South Asians comprise 41% of all admitted patients. Mortality rate was 10% and highest among Saudi males (28.9%). Type 2 diabetes mellitus (T2DM) was the most common comorbidity (45.7%). Almost all patients (99%) had pneumonia. Patients > 50 years were three times more likely to die (confidence interval, CI 1.3-6.9; p = 0.01) from Covid-19. Congestive heart failure (odds ratio OR 19.4, CI-1.5-260.0; p = 0.02) and acute kidney injury (OR 11.7, CI-4.7-28.6; p < 0.001) were significantly associated with higher mortality. Dexamethasone use significantly improved the final outcome based on net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (p < 0.05). In this single-center study, T2DM was very common among hospitalized Covid-19 patients. Patients > 50 years, those with congestive heart failure and acute kidney injury are at higher risk for worse Covid-19 outcome.

摘要

这项回顾性研究旨在描述沙特阿拉伯利雅得一家专门的三级医院中,根据沙特卫生部协议管理的住院成人 COVID-19 合并症,并分析其与死亡率的关系。研究纳入了 2020 年 5 月 1 日至 7 月 31 日期间在 King Salman 医院(KSH)住院的 300 名 PCR 确诊的 SARS-CoV2 感染的成年患者的病历。记录了患者的病史、治疗方法和结局。男性明显多于女性(259 比 41)。南亚人占所有住院患者的 41%。死亡率为 10%,其中沙特男性最高(28.9%)。2 型糖尿病(T2DM)是最常见的合并症(45.7%)。几乎所有患者(99%)都患有肺炎。年龄>50 岁的患者死于 COVID-19 的风险增加了三倍(置信区间,CI 1.3-6.9;p=0.01)。充血性心力衰竭(OR 19.4,CI-1.5-260.0;p=0.02)和急性肾损伤(OR 11.7,CI-4.7-28.6;p<0.001)与更高的死亡率显著相关。根据净重新分类改善(NRI)和综合鉴别改善(IDI),地塞米松的使用显著改善了最终结局(p<0.05)。在这项单中心研究中,T2DM 在住院 COVID-19 患者中非常常见。年龄>50 岁、充血性心力衰竭和急性肾损伤的患者 COVID-19 结局更差的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbab/7661919/788c5e509bbd/gr1_lrg.jpg

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