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血糖失调及其与 COVID-19 死亡率和住院时间的关系。

Glucose dysregulation and its association with COVID-19 mortality and hospital length of stay.

机构信息

Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.

Department of Business Management, Brooklyn College, Brooklyn, NY, USA.

出版信息

Diabetes Metab Syndr. 2022 Mar;16(3):102439. doi: 10.1016/j.dsx.2022.102439. Epub 2022 Feb 24.

Abstract

BACKGROUND AND AIMS

We investigate the impact of blood glucose on mortality and hospital length of stay (HLOS) among COVID-19 patients.

METHODS

Retrospective study of 456 patients with confirmed COVID-19 and glycemic dysregulation in the New York City area.

RESULTS

We found that impaired glucose adjusted for other organs systems involved (OR:1.87; 95% CI:1.36-2.57, p < 0.001), increased glucose nadir (OR:34.28; 95% CI:3.97-296.05, p < 0.01) and abnormal blood glucose levels at discharge (OR:5.07; 95% CI:2.31-11.14, p < 0.001) were each significantly associated with increased odds for mortality. New or higher from baseline insulin requirement during hospitalization (OR:0.34; 95% CI:0.15-0.78; p < 0.05) was significantly associated with decreased odds for mortality. Increased glucose peak (B = 0.001, SE=<0.001, p < 0.001), new or higher from baseline insulin requirement during hospitalization (B = 0.11, SE = 0.03, p < 0.001), and increased days to dysglycemia (B = 0.15, SE = 0.04, p < 0.001) were each significantly associated with increased HLOS. Increased glucose nadir (B = -0.67, SE = 0.07, p < 0.001), insulin intravenous drip (B = -0.10, SE = 0.05, p < 0.05), and increased proportion days endocrine system involved (B = -0.25, SE = 0.06, p < 0.001) were each significantly associated with decreased HLOS.

CONCLUSION

Glucose dysregulation adversely affects mortality and HLOS in COVID-19. These data can help clinicians to guide patient treatment and management in COVID-19 patients.

摘要

背景和目的

我们研究了血糖对纽约市地区 COVID-19 患者死亡率和住院时间(HLOS)的影响。

方法

对 456 名血糖失调的确诊 COVID-19 患者进行回顾性研究。

结果

我们发现,校正其他器官系统受累的葡萄糖(OR:1.87;95%CI:1.36-2.57,p<0.001)、血糖谷值升高(OR:34.28;95%CI:3.97-296.05,p<0.01)和出院时血糖水平异常(OR:5.07;95%CI:2.31-11.14,p<0.001)均与死亡率增加显著相关。住院期间新的或高于基线的胰岛素需求(OR:0.34;95%CI:0.15-0.78;p<0.05)与死亡率降低显著相关。血糖峰值升高(B=0.001,SE<0.001,p<0.001)、住院期间新的或高于基线的胰岛素需求(B=0.11,SE=0.03,p<0.001)和血糖异常发生天数增加(B=0.15,SE=0.04,p<0.001)均与 HLOS 增加显著相关。血糖谷值降低(B=-0.67,SE=0.07,p<0.001)、静脉滴注胰岛素(B=-0.10,SE=0.05,p<0.05)和内分泌系统受累比例天数增加(B=-0.25,SE=0.06,p<0.001)与 HLOS 降低显著相关。

结论

血糖失调对 COVID-19 患者的死亡率和 HLOS 有不利影响。这些数据可以帮助临床医生指导 COVID-19 患者的治疗和管理。

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