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科威特2型糖尿病合并新冠病毒病患者的临床特征及预后

Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait.

作者信息

Alshukry Abdullah, Bu Abbas Mohammad, Ali Yaseen, Alahmad Barrak, Al-Shammari Abdullah A, Alhamar Ghadeer, Abu-Farha Mohammad, AbuBaker Jehad, Devarajan Sriraman, Dashti Ali A, Al-Mulla Fahd, Ali Hamad

机构信息

Department of Otolaryngology & Head and Neck Surgery, Jaber Al-Ahmad Hospital, Ministry of Health, Kuwait.

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.

出版信息

Heliyon. 2021 Apr;7(4):e06706. doi: 10.1016/j.heliyon.2021.e06706. Epub 2021 Apr 5.

Abstract

BACKGROUND

COVID-19 has a highly variable clinical presentation, ranging from asymptomatic to severe respiratory symptoms and death. Diabetes seems to be one of the main comorbidities contributing to a worse COVID-19 outcome.

OBJECTIVE

In here we analyze the clinical characteristics and outcomes of diabetic COVID-19 patients Kuwait.

METHODS

In this single-center, retrospective study of 417 consecutive COVID-19 patients, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic and non-diabetic COVID-19 patients.

RESULTS

COVID-19 patients with diabetes had more ICU admission than non-diabetic COVID-19 patients (20.1% vs. 16.8%, p < 0.001). Diabetic COVID-19 patients also recorded higher mortality in comparison to non-diabetic COVID-19 patients (16.7% vs. 12.1%, p < 0.001). Diabetic COVID-19 patients had significantly higher prevalence of comorbidities, such as hypertension. Laboratory investigations also highlighted notably higher levels of C-reactive protein in diabetic COVID019 patients and lower estimated glomerular filtration rate. They also showed a higher incidence of complications. logistic regression analysis showed that every 1 mmol/L increase in fasting blood glucose in COVID-19 patients is associated with 1.52 (95% CI: 1.34-1.72, p < 0.001) times the odds of dying from COVID-19.

CONCLUSION

Diabetes is a major contributor to worsening outcomes in COVID-19 patients. Understanding the pathophysiology underlining these findings could provide insight into better management and improved outcome of such cases.

摘要

背景

2019冠状病毒病(COVID-19)的临床表现高度可变,从无症状到严重呼吸道症状及死亡。糖尿病似乎是导致COVID-19预后较差的主要合并症之一。

目的

在此我们分析科威特糖尿病COVID-19患者的临床特征和预后。

方法

在这项对417例连续COVID-19患者进行的单中心回顾性研究中,我们分析并比较了糖尿病和非糖尿病COVID-19患者的疾病严重程度、预后、相关并发症及临床实验室检查结果。

结果

糖尿病COVID-19患者入住重症监护病房(ICU)的比例高于非糖尿病COVID-19患者(20.1%对16.8%,p<0.001)。与非糖尿病COVID-19患者相比,糖尿病COVID-19患者的死亡率也更高(16.7%对12.1%,p<0.001)。糖尿病COVID-19患者合并症(如高血压)的患病率显著更高。实验室检查还突出显示,糖尿病COVID-19患者的C反应蛋白水平明显更高,而估算肾小球滤过率更低。他们的并发症发生率也更高。逻辑回归分析显示,COVID-19患者空腹血糖每升高1 mmol/L,死于COVID-19的几率增加1.52倍(95%置信区间:1.34 - 1.72,p<0.001)。

结论

糖尿病是导致COVID-19患者预后恶化的主要因素。了解这些发现背后的病理生理学机制有助于深入了解此类病例的更好管理及改善预后。

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