Myers Alyson K, Kim Tara S, Zhu Xu, Liu Yan, Qiu Michael, Pekmezaris Renee
Department of Internal Medicine, Division of Endocrinology, North Shore University Hospital, Manhasset, New York, USA.
Center for Health Innovations and Outcomes Research, Northwell Health, Manhasset, New York, USA.
J Diabetes. 2021 May;13(5):430-438. doi: 10.1111/1753-0407.13158. Epub 2021 Feb 26.
Diabetes has been identified as a risk factor for intubation and mortality in patients with coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We seek to examine the impact of clinical variables such as glycosylated hemoglobin (HbA1c) on mortality and need for intubation, as well as demographic variables such as age, sex, and race on persons with type 2 diabetes and COVID-19.
Analyses were conducted on 4413 patients with an International Classification of Diseases and Related Health Problems (ICD-10) diagnosis of type 2 diabetes and COVID-19. Survival analysis was conducted using Kaplan-Meier curves and the log-rank test to compare subgroup analyses.
In this multivariate analysis, male gender, older age, and hyperglycemia at admission were associated with increased mortality and intubation, but this was not seen for race, ethnicity, insurance type, or HbA1c. Based on Kaplan-Meier analysis, having comorbid conditions such as hypertension, chronic kidney disease, and coronary artery disease was associated with a statistically significant increased risk of mortality.
Glycemic levels at admission have a greater impact on health outcomes than HbA1c. Older men and those with comorbid disease are also at greater risk for mortality. Further longitudinal studies need to be done to evaluate the impact of COVID-19 on type 2 diabetes.
糖尿病已被确定为新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）患者插管和死亡的危险因素。我们试图研究糖化血红蛋白（HbA1c）等临床变量对2型糖尿病合并COVID-19患者死亡率和插管需求的影响，以及年龄、性别和种族等人口统计学变量的影响。
对4413例国际疾病分类和相关健康问题（ICD-10）诊断为2型糖尿病合并COVID-19的患者进行分析。使用Kaplan-Meier曲线和对数秩检验进行生存分析，以比较亚组分析。
在这项多变量分析中，男性、老年和入院时高血糖与死亡率和插管增加相关，但种族、民族、保险类型或HbA1c未见此关联。根据Kaplan-Meier分析，患有高血压、慢性肾病和冠状动脉疾病等合并症与死亡率显著增加的风险相关。
入院时的血糖水平对健康结局的影响大于HbA1c。老年男性和患有合并症的人死亡风险也更高。需要进一步进行纵向研究以评估COVID-19对2型糖尿病的影响。
