Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Nutrients. 2021 Jun 26;13(7):2199. doi: 10.3390/nu13072199.
This study aimed to determine the relationships among hyperglycemia (HG), the presence of type 2 diabetes (T2D), and the outcomes of COVID-19. Demographic data, blood glucose levels (BG) measured on admission, and hospital outcomes of COVID-19 patients hospitalized at Boston University Medical Center from 1 March to 4 August 2020 were extracted from the hospital database. HG was defined as BG > 200 mg/dL. Patients with type 1 diabetes or BG < 70 mg/dL were excluded. A total of 458 patients with T2D and 976 patients without T2D were included in the study. The mean ± SD age was 56 ± 17 years and 642 (45%) were female. HG occurred in 193 (42%) and 42 (4%) of patients with and without T2D, respectively. Overall, the in-hospital mortality rate was 9%. Among patients without T2D, HG was statistically significantly associated with mortality, ICU admission, intubation, acute kidney injury, and severe sepsis/septic shock, after adjusting for potential confounders ( < 0.05). However, only ICU admission and acute kidney injury were associated with HG among patients with T2D ( < 0.05). Among the 235 patients with HG, the presence of T2D was associated with decreased odds of mortality, ICU admission, intubation, and severe sepsis/septic shock, after adjusting for potential confounders, including BG ( < 0.05). In conclusion, HG in the subset of patients without T2D could be a strong indicator of high inflammatory burden, leading to a higher risk of severe COVID-19.
这项研究旨在确定高血糖 (HG)、2 型糖尿病 (T2D) 存在与 COVID-19 结局之间的关系。从医院数据库中提取了 2020 年 3 月 1 日至 8 月 4 日期间在波士顿大学医学中心住院的 COVID-19 患者的人口统计学数据、入院时测量的血糖水平 (BG) 和住院结局。HG 定义为 BG > 200mg/dL。排除了 1 型糖尿病或 BG < 70mg/dL 的患者。共有 458 例 T2D 患者和 976 例无 T2D 患者纳入研究。平均年龄 ± 标准差为 56 ± 17 岁,642 人(45%)为女性。T2D 患者和无 T2D 患者中分别有 193 例(42%)和 42 例(4%)发生 HG。总体而言,住院死亡率为 9%。在无 T2D 的患者中,在校正潜在混杂因素后,HG 与死亡率、重症监护病房 (ICU) 入院、插管、急性肾损伤和严重脓毒症/脓毒性休克显著相关(<0.05)。然而,在 T2D 患者中,仅 ICU 入院和急性肾损伤与 HG 相关(<0.05)。在 235 例 HG 患者中,在校正潜在混杂因素,包括 BG 后,T2D 的存在与死亡率、ICU 入院、插管和严重脓毒症/脓毒性休克的几率降低相关(<0.05)。总之,在无 T2D 的患者亚组中,HG 可能是高炎症负担的有力指标,导致 COVID-19 严重程度增加的风险更高。