与确诊或临床疑似2019冠状病毒病的糖尿病患者院内死亡率和严重程度相关的风险指标。
Risk indicators associated with in-hospital mortality and severity in patients with diabetes mellitus and confirmed or clinically suspected COVID-19.
作者信息
Pazoki Marzieh, Keykhaei Mohammad, Kafan Samira, Montazeri Mahnaz, Mirabdolhagh Hazaveh Mojgan, Sotoodehnia Mehran, Kazemian Sina, Talebpour Mohammad, Ashraf Haleh, Shariat Moharari Reza, Majidi Fazeleh, Hedayati Amlashi Nazanin, Zare Sara, Fathi Maryam, Azimbeik Zohre, Ebrahimi Mehdi
机构信息
Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
出版信息
J Diabetes Metab Disord. 2021 Jan 7;20(1):59-69. doi: 10.1007/s40200-020-00701-2. eCollection 2021 Jun.
PURPOSE
This study aims to investigate risk indicators of in-hospital mortality and severity of coronavirus disease-2019 (COVID-19) in patients with diabetes mellitus (DM).
METHODS
In this retrospective study, we studied patients with COVID-19 referred to Sina Hospital, Tehran, Iran, from February 20 to May 14, 2020. Patients with either a positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens or high clinical suspicion according to the World Health Organization interim guidance were included. We accurately divided all patients into two groups based on diabetes affection and followed-up patients with DM based on incurring death, severe COVID-19, and in-hospital complications.
RESULTS
We enrolled 574 patients with COVID-19 in the final analysis, of whom 176 (30.7%) patients had DM. In this study, 104 (18.1%) patients deceased, and 380 (66.2%) patients incurred severe COVID-19. We found that COVID-19 patients with DM had a significantly higher mortality rate ( value<0.001), severe disease ( value<0.001), and in-hospital complications (all values<0.05). Besides that, in patients with DM, admission temperature (odds ratio (OR): 1.69, P value: 0.024), oxygen saturation (OR: 0.92, P value: 0.004), and urea (OR: 1.01, P value: 0.048) were independent risk indicators of in-hospital mortality. In addition, subgroup analysis of diabetic patients based on admission glucose level showed significant differences between these groups regarding acute cardiac injury ( value: 0.044) and acute liver injury (P value: 0.002).
CONCLUSIONS
Patients with DM admitted with lower oxygen saturation, elevated temperature, and higher urea are more susceptible to progress to more severe COVID-19 and poor prognosis. This indicates a necessity for more precise care during hospitalization for these patients.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-020-00701-2.
目的
本研究旨在调查糖尿病（DM）患者中2019冠状病毒病（COVID-19）的院内死亡率及严重程度的风险指标。
方法
在这项回顾性研究中，我们研究了2020年2月20日至5月14日转诊至伊朗德黑兰西娜医院的COVID-19患者。纳入拭子标本实时逆转录聚合酶链反应检测呈阳性或根据世界卫生组织临时指南临床高度怀疑的患者。我们根据糖尿病患病情况将所有患者准确分为两组，并对糖尿病患者的死亡、严重COVID-19和院内并发症情况进行随访。
结果
最终分析纳入了574例COVID-19患者，其中176例（30.7%）患有糖尿病。本研究中，104例（18.1%）患者死亡，380例（66.2%）患者发生严重COVID-19。我们发现，患有糖尿病的COVID-19患者死亡率（值<0.001）、重症疾病（值<0.001）和院内并发症（所有值<0.05）显著更高。除此之外，在糖尿病患者中，入院时体温（比值比（OR）：1.69，P值：0.024）、血氧饱和度（OR：0.92，P值：0.004）和尿素（OR：1.01，P值：0.048）是院内死亡的独立风险指标。此外，根据入院血糖水平对糖尿病患者进行亚组分析显示，这些组在急性心脏损伤（值：0.044）和急性肝损伤（P值：0.002）方面存在显著差异。
结论
入院时血氧饱和度较低、体温升高和尿素水平较高的糖尿病患者更容易进展为更严重的COVID-19且预后较差。这表明对这些患者住院期间进行更精确护理的必要性。
补充信息
网络版包含可在10.1007/s40200-020-
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