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2019冠状病毒病背景下医院对高血糖的管理:循证临床考量

Hospital management of hyperglycemia in the context of COVID-19: evidence-based clinical considerations.

作者信息

Mendes Thiago Bosco, Câmara-de-Souza Alexandre Barbosa, Halpern Bruno

机构信息

Department of Internal Medicine, Hospital das Clínicas, São Paulo State University (UNESP), Botucatu, Brazil.

Department of Endocrinology, Hospital das Clínicas, University of São Paulo (USP), São Paulo, Brazil.

出版信息

Diabetol Metab Syndr. 2022 Mar 4;14(1):37. doi: 10.1186/s13098-022-00808-x.

Abstract

The COVID-19 pandemic led to an unprecedented crisis, and early on, it has been shown that diabetes is an important risk factor for complications and mortality in infected patients, as demonstrated by several studies. Moreover, hyperglycemia, regardless of whether patients have diabetes, is associated with poorer outcomes, which suggests that adequate monitoring and treatment of elevated glycemia in the hospital setting can improve patient outcomes. In patients with COVID-19, glycemic control may be impaired as a consequence of the infection itself (aggravating pre-existing diabetes and potentially precipitating new-onset diabetes), inflammation, or corticosteroid use-a well-established therapy to reduce COVID-19 complications, especially in the intensive care unit. This article reviews the link between diabetes and hyperglycemia, and COVID-19, with a brief review of potential mechanisms, along with emerging evidence on the effect of glycemic control on COVID-19 outcomes, especially in hospital settings.

摘要

新冠疫情引发了一场前所未有的危机,早期已有多项研究表明,糖尿病是感染患者出现并发症和死亡的重要风险因素。此外,无论患者是否患有糖尿病,高血糖都与较差的预后相关,这表明在医院环境中对血糖升高进行充分监测和治疗可改善患者预后。在新冠患者中,血糖控制可能因感染本身(加重已有的糖尿病并可能引发新发糖尿病)、炎症或使用皮质类固醇(一种成熟的用于减少新冠并发症的治疗方法,尤其是在重症监护病房)而受损。本文回顾了糖尿病和高血糖与新冠之间的联系,简要介绍了潜在机制,以及血糖控制对新冠预后影响的新证据,特别是在医院环境中的证据。

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