Children's Cancer Institute, Faculty of Medicine, University of New South Wales, Australia; Disease Biology and Molecular Epidemiology Research Group, Chattogram, 4000, Bangladesh.
Intensive Care Unit, 250 Bedded General Hospital, Chattogram, 4000, Bangladesh.
Diabetes Metab Syndr. 2021 Jan-Feb;15(1):229-235. doi: 10.1016/j.dsx.2020.12.037. Epub 2020 Dec 30.
Diabetes mellitus is highly prevalent among critical cases of coronavirus disease 2019 (COVID-19) with poor outcomes. This study aimed to describe the clinical characteristics and outcomes of COVID-19 patients with diabetes, admitted in the intensive care unit (ICU) of the southern region of Bangladesh.
Epidemiological, clinical, laboratory, treatments, complications, and clinical outcomes data were extracted from electronic medical records of 168 COVID-19 patients admitted into ICU of two COVID-19 dedicated hospitals of Chattogram, Bangladesh and compared between diabetes (n = 88) and non-diabetes (n = 80) groups.
The prevalence of diabetes was high among 51-70 years old patients. All the diabetic patients had at least one other comorbidity, with a significantly higher incidence of hypertension (53.4% vs 27.5%, P < 0.05). Prevalence of male patients (74/88; 84.1%) was slightly higher among diabetic patients than the non-diabetic patients (60/80; 75%). Even though not significant, Kaplan-Meier survival curve showed that COVID-19 patients with diabetes had a shorter overall survival time than those without diabetes. In subgroup analysis, diabetic patients were classified into insulin-requiring and non-insulin-requiring groups based on their requirement of insulin during the stay in ICU. COVID-19 infected diabetic patients requiring insulin have high risk of disease progression and shorter survival time than the non-insulin required group.
Diabetes is an independent risk factor for the poor prognosis of COVID-19. More attention should be paid to the prevention and prompt treatment of diabetic patients, to maintain good glycaemic control especially those who require insulin therapy.
糖尿病在 2019 年冠状病毒病（COVID-19）重症病例中患病率较高，且预后较差。本研究旨在描述孟加拉国南部地区重症监护病房（ICU）中 COVID-19 合并糖尿病患者的临床特征和结局。
从孟加拉国 Chattogram 市两家 COVID-19 定点医院 ICU 中 168 例 COVID-19 患者的电子病历中提取流行病学、临床、实验室、治疗、并发症和临床结局数据，并比较糖尿病（n=88）和非糖尿病（n=80）组之间的差异。
糖尿病在 51-70 岁患者中的患病率较高。所有糖尿病患者均至少合并一种其他疾病，其中高血压的发病率显著更高（53.4%比 27.5%，P<0.05）。与非糖尿病患者（60/80；75%）相比，糖尿病患者中男性患者（74/88；84.1%）的比例略高。虽然无统计学意义，但 Kaplan-Meier 生存曲线显示，COVID-19 合并糖尿病患者的总生存时间短于非糖尿病患者。在亚组分析中，根据患者在 ICU 期间是否需要胰岛素，将糖尿病患者分为胰岛素依赖组和非胰岛素依赖组。需要胰岛素的 COVID-19 感染糖尿病患者疾病进展和生存时间更短的风险较高。
糖尿病是 COVID-19 预后不良的独立危险因素。应更加关注糖尿病患者的预防和及时治疗，尤其应保持良好的血糖控制，对于需要胰岛素治疗的患者更应如此。
