Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Scientific Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2021 Mar 30;12:640529. doi: 10.3389/fendo.2021.640529. eCollection 2021.
This retrospective study examined changes in fasting blood glucose (FBG) levels during hospitalization and their effect on risk of death for Coronavirus disease 2019 (COVID-19) patients without previously diagnosed diabetes. A model with low- and high-stable pattern trajectories was established based on a longitudinal change in FBG levels. We analyzed FBG trajectory-associated clinical features and risk factors for death due to COVID-19. Of the 230 enrolled patients, 44 died and 87.83% had a low-stable pattern (average FBG range: 6.63-7.54 mmol/L), and 12.17% had a high-stable pattern (average FBG range: 12.59-14.02 mmol/L). There were statistical differences in laboratory findings and case fatality between the two FBG patterns. Multivariable logistic regression analysis showed that increased neutrophil count (odds ratio [OR], 25.43; 95% confidence interval [CI]: 2.07, 313.03), elevated direct bilirubin (OR, 5.80; 95%CI: 1.72, 19.58), elevated creatinine (OR, 26.69; 95% CI: 5.82, 122.29), lymphopenia (OR, 8.07; 95% CI: 2.70, 24.14), and high-stable FBG pattern (OR, 8.79; 95% CI: 2.39, 32.29) were independent risk factors for higher case fatality in patients with COVID-19 and hyperglycemia but no history of diabetes. FBG trajectories were significantly associated with death risk in patients with COVID-19 and no diabetes.
本回顾性研究探讨了新冠肺炎（COVID-19）住院患者空腹血糖（FBG）水平的变化及其对无既往诊断糖尿病患者死亡风险的影响。根据 FBG 水平的纵向变化，建立了低稳定模式和高稳定模式轨迹模型。我们分析了与 FBG 轨迹相关的临床特征和 COVID-19 死亡的危险因素。在 230 名纳入患者中，44 人死亡，87.83%为低稳定模式（平均 FBG 范围：6.63-7.54mmol/L），12.17%为高稳定模式（平均 FBG 范围：12.59-14.02mmol/L）。两种 FBG 模式之间的实验室发现和病死率存在统计学差异。多变量 logistic 回归分析显示，中性粒细胞计数增加（优势比[OR]，25.43；95%置信区间[CI]：2.07，313.03）、直接胆红素升高（OR，5.80；95%CI：1.72，19.58）、肌酐升高（OR，26.69；95%CI：5.82，122.29）、淋巴细胞减少（OR，8.07；95%CI：2.70，24.14）和高稳定 FBG 模式（OR，8.79；95%CI：2.39，32.29）是 COVID-19 伴高血糖但无糖尿病患者病死率较高的独立危险因素。FBG 轨迹与 COVID-19 无糖尿病患者的死亡风险显著相关。
