Institute of Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Infection Division, Wuhan Huoshenshan Hospital, Wuhan 430030, China.
Mediators Inflamm. 2021 Mar 18;2021:8812304. doi: 10.1155/2021/8812304. eCollection 2021.
Coronavirus disease 2019 (COVID-19) is a considerable global public health threat. This study sought to investigate whether blood glucose (BG) levels or comorbid diabetes are associated with inflammatory status and disease severity in patients with COVID-19.
In this retrospective cohort study, the clinical and biochemical characteristics of COVID-19 patients with or without diabetes were compared. The relationship among severity of COVID-19, inflammatory status, and diabetes or hyperglycemia was analyzed. The severity of COVID-19 in all patients was determined according to the diagnostic and treatment guidelines issued by the Chinese National Health Committee (7th edition).
Four hundred and sixty-one patients were enrolled in our study, and 71.58% of patients with diabetes and 13.03% of patients without diabetes had hyperglycemia. Compared with patients without diabetes ( = 366), patients with diabetes ( = 95) had a higher leucocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR). There was no association between severity of COVID-19 and known diabetes adjusted for age, sex, body mass index (BMI), known hypertension, and coronary heart disease. The leucocyte count, NLR, and C-reactive protein (CRP) level increased with increasing BG level. Hyperglycemia was an independent predictor of critical (OR 4.00, 95% CI 1.72-9.30) or severe (OR 3.55, 95% CI 1.47-8.58) COVID-19, and of increased inflammatory levels (high leucocyte count (OR 4.26, 95% CI 1.65-10.97), NLR (OR 2.76, 95% CI 1.24-6.10), and CRP level (OR 2.49, 95% CI 1.19-5.23)), after adjustment for age, sex, BMI, severity of illness, and known diabetes.
Hyperglycemia was positively correlated with higher inflammation levels and more severe illness, and it is a risk factor for the increased severity of COVID-19. The initial measurement of plasma glucose levels after hospitalization may help identify a subset of patients who are predisposed to a worse clinical course.
2019 年冠状病毒病（COVID-19）是一项重大的全球公共卫生威胁。本研究旨在探讨 COVID-19 患者的血糖（BG）水平或合并糖尿病是否与炎症状态和疾病严重程度相关。
在这项回顾性队列研究中，比较了合并糖尿病和不合并糖尿病的 COVID-19 患者的临床和生化特征。分析了 COVID-19 严重程度、炎症状态与糖尿病或高血糖之间的关系。所有患者的 COVID-19 严重程度均根据中国国家卫生健康委员会发布的诊断和治疗指南（第 7 版）确定。
本研究共纳入 461 例患者，其中 71.58%的糖尿病患者和 13.03%的非糖尿病患者存在高血糖。与无糖尿病患者（=366）相比，糖尿病患者（=95）的白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值（NLR）和红细胞沉降率（ESR）更高。在调整年龄、性别、体重指数（BMI）、已知高血压和冠心病后，COVID-19 的严重程度与已知糖尿病之间没有关联。白细胞计数、NLR 和 C 反应蛋白（CRP）水平随 BG 水平的升高而升高。高血糖是重症（OR 4.00，95%CI 1.72-9.30）或严重（OR 3.55，95%CI 1.47-8.58）COVID-19 的独立预测因子，也是炎症水平升高的独立预测因子（高白细胞计数（OR 4.26，95%CI 1.65-10.97）、NLR（OR 2.76，95%CI 1.24-6.10）和 CRP 水平（OR 2.49，95%CI 1.19-5.23）），在调整年龄、性别、BMI、疾病严重程度和已知糖尿病后。
高血糖与更高的炎症水平和更严重的疾病呈正相关，是 COVID-19 严重程度增加的危险因素。住院后初始测量血浆葡萄糖水平可能有助于识别具有更差临床病程倾向的患者亚组。
