Department of Endocrinology, Mediclinic Parkview Hospital, Dubai, United Arab Emirates.
Department of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
JMIR Public Health Surveill. 2020 Dec 7;6(4):e22471. doi: 10.2196/22471.
Recent studies have shown that diabetes is a major risk factor that contributes to the severity of COVID-19 and resulting mortality. Poor glycemic control is also associated with poor patient outcomes (eg, hospitalization and death).
This study aimed to describe the clinical characteristics and outcomes of patients with diabetes who were admitted to our hospital for COVID-19 treatment.
This cross-sectional, observational study comprised patients with diabetes admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates, from March 30 to June 7, 2020. We studied the differences among characteristics, length of hospital stay, diabetes status, comorbidities, treatments, and outcomes among these patients.
Of the cohort patients, 25.1% (103/410) had coexistent diabetes or prediabetes. These patients represented 17 different ethnicities, with 59.2% (61/103) from Asian countries and 35% (36/103) from Arab countries. Mean patient age was 54 (SD 12.5) years, and 66.9% (69/103) of patients were male. Moreover, 85.4% (88/103) of patients were known to have diabetes prior to admission, and 14.6% (15/103) were newly diagnosed with either diabetes or prediabetes at admission. Most cohort patients had type 2 diabetes or prediabetes, and only 2.9% (3/103) of all patients had type 1 diabetes. Furthermore, 44.6% (46/103) of patients demonstrated evidence suggesting good glycemic control during the 4-12 weeks prior to admission, as defined arbitrarily by admission hemoglobin A1 level <7.5%, and 73.8% (76/103) of patients had other comorbidities, including hypertension, ischemic heart disease, and dyslipidemia. Laboratory data (mean and SD values) at admission for patients who needed ward-based care versus those who needed intensive care were as follows: fibrinogen, 462.8 (SD 125.1) mg/dL vs 660.0 (SD 187.6) mg/dL; D-dimer, 0.7 (SD 0.5) µg/mL vs 2.3 (SD 3.5) µg/mL; ferritin, 358.0 (SD 442.0) mg/dL vs 1762.4 (SD 2586.4) mg/dL; and C-reactive protein, 33.9 (SD 38.6) mg/L vs 137.0 (SD 111.7) mg/L. Laboratory data were all significantly higher for patients in the intensive care unit subcohort (P<.05). The average length of hospital stay was 14.55 days for all patients, with 28.2% (29/103) of patients requiring intensive care. In all, 4.9% (5/103) died during hospitalization-all of whom were in the intensive care unit.
Majority of patients with diabetes or prediabetes and COVID-19 had other notable comorbidities. Only 4 patients tested negative for COVID-19 RT-PCR but showed pathognomonic changes of COVID-19 radiologically. Laboratory analyses revealed distinct abnormal patterns of biomarkers that were associated with a poor prognosis: fibrinogen, D-dimer, ferritin, and C-reactive protein levels were all significantly higher at admission in patients who subsequently needed intensive care than in those who needed ward-based care. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes within the UAE region.
最近的研究表明，糖尿病是导致 COVID-19 严重程度和死亡率的主要危险因素。血糖控制不佳也与患者预后不良（例如住院和死亡）有关。
本研究旨在描述因 COVID-19 入住我院的糖尿病患者的临床特征和转归。
本横断面、观察性研究纳入了 2020 年 3 月 30 日至 6 月 7 日期间因 COVID-19 入住阿拉伯联合酋长国迪拜 Mediclinic Parkview 医院的糖尿病患者。我们研究了这些患者在特征、住院时间、糖尿病状况、合并症、治疗和结局方面的差异。
队列患者中，25.1%（103/410）同时患有糖尿病或前期糖尿病。这些患者来自 17 个不同的种族，其中 59.2%（61/103）来自亚洲国家，35%（36/103）来自阿拉伯国家。患者平均年龄为 54（SD 12.5）岁，66.9%（69/103）为男性。此外，85.4%（88/103）的患者在入院前已知患有糖尿病，14.6%（15/103）在入院时新诊断为糖尿病或前期糖尿病。大多数队列患者患有 2 型糖尿病或前期糖尿病，只有 2.9%（3/103）的患者患有 1 型糖尿病。此外，44.6%（46/103）的患者在入院前 4-12 周内有证据表明血糖控制良好，任意定义为入院时血红蛋白 A1 水平<7.5%，73.8%（76/103）的患者有其他合并症，包括高血压、缺血性心脏病和血脂异常。需要住院治疗和需要重症监护的患者的入院时实验室数据（平均值和标准差）如下：纤维蛋白原，462.8（SD 125.1）mg/dL 比 660.0（SD 187.6）mg/dL；D-二聚体，0.7（SD 0.5）μg/mL 比 2.3（SD 3.5）μg/mL；铁蛋白，358.0（SD 442.0）mg/dL 比 1762.4（SD 2586.4）mg/dL；C 反应蛋白，33.9（SD 38.6）mg/L 比 137.0（SD 111.7）mg/L。重症监护病房亚组患者的实验室数据均显著升高（P<.05）。所有患者的平均住院时间为 14.55 天，28.2%（29/103）的患者需要重症监护。共有 4 名患者 COVID-19 RT-PCR 检测结果为阴性，但影像学检查显示 COVID-19 的特征性改变。实验室分析显示，与预后不良相关的生物标志物存在明显异常模式：纤维蛋白原、D-二聚体、铁蛋白和 C 反应蛋白水平在随后需要重症监护的患者入院时均显著高于仅需住院治疗的患者。需要进行更多具有更大样本量的研究，以比较在阿拉伯联合酋长国内患有和不患有糖尿病的 COVID-19 患者的数据。
