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COVID-19 合并糖尿病患者的临床特征。

Clinical Findings in Diabetes Mellitus Patients with COVID-19.

机构信息

Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China.

Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China.

出版信息

J Diabetes Res. 2021 Jan 8;2021:7830136. doi: 10.1155/2021/7830136. eCollection 2021.

Abstract

BACKGROUNDS

Diabetes mellitus (DM) is one of the most common comorbidities in patients with coronavirus disease (COVID-19). We aim to summarize the clinical features of DM patients with COVID-19 and find out potential factors associated with severe disease.

METHODS

In this retrospective, single-center study, the medical records of patients with COVID-19 in Changsha, Hunan, China, from January 21, 2020, to February 19, 2020, were reviewed. Epidemiological information, clinical features, and outcomes were compared between DM patients admitted to the intensive care unit (ICU) or not.

RESULTS

A total of 241 patients confirmed with COVID-19 were enrolled, including 19 DM patients. There were more patients in DM group admitted to the ICU than non-DM group (36.8% vs. 15.8%, = 0.045). Compared with non-DM group in the ICU, there were more female patients from DM group in the ICU (85.7% vs. 31.4%, = 0.024). On admission, the mean level of glycated hemoglobin A1c (HbA1c) was higher in the ICU DM patients than that in the non-ICU DM patients (8.5% vs. 7.1%). There were more DM patients with proteinuria in the ICU group than the non-ICU group (57.1% vs. 33.3%). Twelve DM patients (63.2%) changed diabetic therapy during hospitalization, and all DM patients admitted to the ICU used insulin. As of March 14, all 19 DM patients have been discharged, and no death occurred.

CONCLUSIONS

DM patients with COVID-19 are vulnerable to severe disease, especially for female patients. High levels of HbA1c and proteinuria could be potential risk factors for severe COVID-19 in DM patients. In addition to timely systemic therapy, the control of blood glucose and proper diabetic therapy is essential to improve the prognosis of severe DM patients with COVID-19.

摘要

背景

糖尿病(DM)是冠状病毒病(COVID-19)患者最常见的合并症之一。我们旨在总结 COVID-19 合并 DM 患者的临床特征,并找出与重症相关的潜在因素。

方法

在这项回顾性、单中心研究中,我们回顾了 2020 年 1 月 21 日至 2 月 19 日期间在中国湖南长沙 COVID-19 患者的病历。比较了入住重症监护病房(ICU)和未入住 ICU 的 DM 患者的流行病学信息、临床特征和结局。

结果

共纳入 241 例确诊 COVID-19 患者,其中 19 例为 DM 患者。DM 组入住 ICU 的患者多于非 DM 组(36.8%比 15.8%, = 0.045)。与 ICU 中非 DM 组相比,ICU 中 DM 组女性患者更多(85.7%比 31.4%, = 0.024)。入院时,ICU 中 DM 患者的糖化血红蛋白 A1c(HbA1c)水平高于非 ICU 中 DM 患者(8.5%比 7.1%)。ICU 组 DM 患者蛋白尿的比例高于非 ICU 组(57.1%比 33.3%)。12 例 DM 患者(63.2%)在住院期间改变了糖尿病治疗方案,所有入住 ICU 的 DM 患者均使用胰岛素。截至 3 月 14 日,19 例 DM 患者均已出院,无死亡病例。

结论

COVID-19 合并 DM 的患者易患重症,尤其是女性患者。高 HbA1c 和蛋白尿可能是 DM 患者 COVID-19 重症的潜在危险因素。除了及时进行全身治疗外,控制血糖和适当的糖尿病治疗对于改善 COVID-19 重症 DM 患者的预后至关重要。

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