Al Argan Reem, Alkhafaji Dania, Al Elq Abdulmohsen, Albaker Waleed, Alqatari Safi, Alzaki Alaa, Alwaheed Abrar, Al Said Abir, Bukhari Huda, Al Warthan Sara, Zeeshan Mohammad, AlRubaish Fatimah, AlElq Zainab, Alsahlawi Ahmed, Alalwan Mohannad, AlHwiesh Amani, Alabdrabalnabi Fatimah I
Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia.
Department of Medical Education, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia.
Int J Gen Med. 2021 Dec 6;14:9445-9457. doi: 10.2147/IJGM.S338800. eCollection 2021.
Diabetes mellitus (DM) has been reported to be associated with a worse outcome of COVID-19 infection. The evidence is scarce in the Middle East and Saudi Arabia. We aimed to evaluate the impact of diabetes mellitus and hyperglycemia in non-diabetic individuals on the severity and outcome of COVID-19 infection.
This is a retrospective observational study, which included patients with confirmed COVID-19 infection [RT-PCR positive for SARS-CoV2] who were admitted to King Fahd Hospital of the University-Khobar-Eastern Province-Saudi Arabia from March to September 2020. Baseline demographic data, laboratory investigations, and markers of the severity of COVID-19 were analyzed. The collected data were categorized according to the Saudi Arabian Ministry of Health COVID-19 infection severity criteria. Patients were divided into three groups as follows: patients in Group 1 had pre-existing DM, patients in Group 2 did not have DM but were documented to have hyperglycemia at presentation, and patients in Group 3 were neither diabetics nor hyperglycemics at presentation and served as the control group. The severity and outcome of the control group were compared with the other two groups. The effect of risk factors on the severity and outcome of COVID-19 infection was studied in the DM group.
A total of 414 patients were included (70.5% males and 29.5% females). The mean age (SD) of patients was 52.3 (±15.5) years. Compared to the control group, pre-existing DM was found to be significantly associated with severe (OR 3.61), critical disease (OR 4.32), intensive care unit (ICU) admission (OR 2.0), and death (OR 2.0) from COVID-19 infection. Hyperglycemia without known DM was also found to be associated with critical COVID-19 pneumonia (P 0.001), and had longer duration of hospitalization (P 0.014), higher ICU admission, mechanical ventilation, and death from COVID-19 infection (P < 0.0001).
Diabetes mellitus and hyperglycemia at presentation, even in the absence of pre-existing DM, are independent risk factors for disease severity and worse outcome of COVID-19 infection. These patients should be identified and managed accordingly. The COVID-19 vaccination program should also target those populations to improve their outcomes.
据报道，糖尿病（DM）与2019冠状病毒病（COVID-19）感染的不良预后相关。在中东和沙特阿拉伯，这方面的证据很少。我们旨在评估糖尿病和非糖尿病个体的高血糖对COVID-19感染的严重程度和预后的影响。
这是一项回顾性观察研究，纳入了2020年3月至9月期间入住沙特阿拉伯东部省胡拜尔法赫德国王大学医院的确诊COVID-19感染患者[严重急性呼吸综合征冠状病毒2（SARS-CoV2）逆转录聚合酶链反应（RT-PCR）呈阳性]。分析了基线人口统计学数据、实验室检查结果以及COVID-19严重程度的标志物。收集的数据根据沙特阿拉伯卫生部的COVID-19感染严重程度标准进行分类。患者分为三组：第1组患者患有既往糖尿病；第2组患者没有糖尿病，但在就诊时记录有高血糖；第3组患者在就诊时既不是糖尿病患者也不是高血糖患者，作为对照组。将对照组的严重程度和预后与其他两组进行比较。在糖尿病组中研究了危险因素对COVID-19感染严重程度和预后的影响。
共纳入414例患者（男性占70.5%，女性占29.5%）。患者的平均年龄（标准差）为52.3（±15.5）岁。与对照组相比，发现既往糖尿病与COVID-19感染导致的重症（比值比[OR]3.61）、危重症（OR 4.32）、入住重症监护病房（ICU）（OR 2.0）和死亡（OR 2.0）显著相关。无已知糖尿病的高血糖也与重症COVID-19肺炎相关（P<0.001），且住院时间更长（P<0.014），入住ICU、机械通气以及因COVID-19感染死亡的比例更高（P<0.0001）。
就诊时的糖尿病和高血糖，即使不存在既往糖尿病，也是疾病严重程度和COVID-19感染不良预后的独立危险因素。应识别并相应管理这些患者。COVID-19疫苗接种计划也应以这些人群为目标，以改善其预后。
