National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory for Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
The First Hospital of Changsha, The Hospital of Infectious Diseases of Changsha, The Public Health Treatment Center of Changsha, Changsha, Hunan, China.
J Med Virol. 2022 May;94(5):1967-1975. doi: 10.1002/jmv.27556. Epub 2022 Jan 8.
We aimed to assess whether blood glucose control can be used as predictors for the severity of 2019 coronavirus disease (COVID-19) and to improve the management of diabetic patients with COVID-19. A two-center cohort with a total of 241 confirmed cases of COVID-19 with definite outcomes was studied. After the diagnosis of COVID-19, the clinical data and laboratory results were collected, the fasting blood glucose levels were followed up at initial, middle stage of admission and discharge, the severity of the COVID-19 was assessed at any time from admission to discharge. Hyperglycemia patients with COVID-19 were divided into three groups: good blood glucose control, fair blood glucose control, and blood glucose deterioration. The relationship of blood glucose levels, blood glucose control status, and severe COVID-19 were analyzed by univariate and multivariable regression analysis. In our cohort, 21.16% were severe cases and 78.84% were nonsevere cases. Admission hyperglycemia (adjusted odds ratio [aOR], 1.938; 95% confidence interval [95% CI], 1.387-2.707), mid-term hyperglycemia (aOR, 1.758; 95% CI, 1.325-2.332), and blood glucose deterioration (aOR, 22.783; 95% CI, 2.661-195.071) were identified as the risk factors of severe COVID-19. Receiver operating characteristic (ROC) curve analysis, reaching an area under ROC curve of 0.806, and a sensitivity and specificity of 80.40% and 68.40%, respectively, revealed that hyperglycemia on admission and blood glucose deterioration of diabetic patients are potential predictive factors for severe COVID-19. Our results indicated that admission hyperglycemia and blood glucose deterioration were positively correlated with the risk factor for severe COVID-19, and deterioration of blood glucose may be more likely to the occurrence of severe illness in COVID-19.
评估血糖控制能否用于预测 2019 年冠状病毒病（COVID-19）的严重程度，并改善 COVID-19 糖尿病患者的管理。研究了共有 241 例确诊 COVID-19 病例的两个中心队列，且均有明确结局。COVID-19 诊断后，收集临床数据和实验室结果，在入院初期、中期和出院时监测空腹血糖水平，在入院至出院期间的任何时间评估 COVID-19 的严重程度。将 COVID-19 伴高血糖患者分为三组：血糖控制良好、血糖控制一般和血糖恶化。采用单因素和多因素回归分析，分析血糖水平、血糖控制状态与严重 COVID-19 的关系。在本队列中，21.16%为重症病例，78.84%为非重症病例。入院时高血糖（调整优势比[aOR]，1.938；95%置信区间[95%CI]，1.387-2.707）、中期高血糖（aOR，1.758；95%CI，1.325-2.332）和血糖恶化（aOR，22.783；95%CI，2.661-195.071）被确定为重症 COVID-19 的危险因素。受试者工作特征（ROC）曲线分析，ROC 曲线下面积为 0.806，敏感性和特异性分别为 80.40%和 68.40%，表明糖尿病患者入院时高血糖和血糖恶化是重症 COVID-19 的潜在预测因素。结果：入院时高血糖和血糖恶化与重症 COVID-19 的危险因素呈正相关，血糖恶化更可能导致 COVID-19 发生重症。
