Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China.
J Cell Mol Med. 2021 Apr;25(7):3484-3497. doi: 10.1111/jcmm.16431. Epub 2021 Mar 10.
Patients with hyperglycemia tend to be susceptible to Coronavirus disease 2019 (COVID-19). However, the association of HbA1c level with outcome of COVID-19 patients was unclear. We performed a retrospective study of 2880 cases of COVID-19 admitted in Tongji Hospital, Wuhan, China, among which 922 had detected the HbA1c levels. We found that COVID-19 patients with either lower levels of HbAlc (3%-4.9%) or higher levels of HbAlc (≥6%) were associated with elevated all-cause mortality. Meanwhile, we observed that HbAlc levels were highly correlated with haemoglobin (Hb) and total cholesterol (TC) (P < .0001), moderately correlated with albumin (ALB) and high-sensitive C reaction protein (hs-CRP) (0.0001 < P<.001), and relatively low correlated with low-density lipoprotein cholesterol (LDL-C) (.001 < P<.01). These associated cofactors might together contribute to the clinical outcome of COVID-19 patients. Furthermore, the mortality was higher in COVID-19 patients with newly diagnosed diabetes mellitus (DM) compared with COVID-19 patients with history of DM. Moreover, in patients with history of DM, the mortality was decreased in patients treated with anti-hyperglycaemic drugs. In summary, our data showed that the in-hospital mortality was increased in COVID-19 patients with lower or higher levels of HbAlc. Meanwhile, initiation of appropriate anti-hyperglycaemic treatment might improve the clinical outcome in COVID-19 patients.
高血糖患者往往易感染 2019 年冠状病毒病（COVID-19）。然而，HbA1c 水平与 COVID-19 患者结局的关系尚不清楚。我们对中国武汉同济医院收治的 2880 例 COVID-19 患者进行了回顾性研究，其中 922 例检测了 HbA1c 水平。我们发现，HbA1c 水平较低（3%-4.9%）或较高（≥6%）的 COVID-19 患者全因死亡率升高。同时，我们观察到 HbA1c 水平与血红蛋白（Hb）和总胆固醇（TC）高度相关（P<.0001），与白蛋白（ALB）和高敏 C 反应蛋白（hs-CRP）中度相关（0.0001<P<.001），与低密度脂蛋白胆固醇（LDL-C）相关性较低（.001<P<.01）。这些相关的合并症可能共同导致 COVID-19 患者的临床结局。此外，新发糖尿病（DM）患者的死亡率高于有 DM 病史的 COVID-19 患者。此外，在有 DM 病史的患者中，接受降血糖药物治疗的患者死亡率降低。总之，我们的数据表明，HbA1c 水平较低或较高的 COVID-19 患者住院死亡率增加。同时，启动适当的降糖治疗可能改善 COVID-19 患者的临床结局。
