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2型糖尿病合并新型冠状病毒肺炎患者死亡率、入住重症监护病房需求及通气需求的评估

Assessment of Mortality Rate, Need for ICU Admission and Ventilation in COVID-19 Patients with Diabetes Mellitus.

作者信息

Zakerkish Mehrnoosh, Fooladi Maryam Shaabanpour, Shahbazian Hajieh Bibi, Ahmadi Fatemeh, Peyman Payami Seyed, Dargahi-Malamir Mehrdad

机构信息

Diabetes research center, Health research institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran E-mail:

Department of Infectious Diseases, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Qatar Med J. 2022 Mar 1;2022(1):9. doi: 10.5339/qmj.2022.9. eCollection 2022.

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19) has become a threat to public health. People with chronic diseases, such as diabetes, are at a greater risk of severe diseases and death upon contracting this new disease. Due to the novelty of COVID-19, no specific information is available about the degree of its mortality and risk factors among diabetic patients. Therefore, this study aims to compare diabetic and nondiabetic COVID-19 patients regarding mortality rate, the need for intensive care unit (ICU) admission, invasive and noninvasive ventilation, and the associated risk factors.

METHODS

This was a cross-sectional study performed on the medical records of 650 adult COVID-19 patients (325 diabetics and 325 nondiabetics) admitted to Razi Hospital in Ahvaz from March 2020 to September 2020.

RESULTS

The mean age of the patients was 61.3 years in the diabetic group and 52.3 years in the nondiabetic group. Men comprised 48.3% of the diabetic group and 59.7% of the nondiabetic group. Diabetic patients suffered from significantly more underlying diseases, such as ischemic heart disease (IHD), hypertension (HTN), chronic kidney disease (CKD), and acute renal failure (ARF) compared to the nondiabetic group ( < 0.0001). Also, when compared with the nondiabetic group, the diabetic group had a significantly higher mortality rate (17.5% vs. 12%;  = 0.047, respectively), more ICU admissions (35.4% vs. 27.7%;  = 0.035, respectively), and a greater need for invasive ventilation (17.5% vs. 11.4%;  = 0.026, respectively).

CONCLUSION

In diabetic patients, the mortality rate, need for ICU admission, and need for invasive ventilation were significantly higher than nondiabetic patients. Our logistic regression analysis in diabetic patients with COVID-19 showed that age, CKD, and ARF were the risk factors affecting mortality. In contrast, age and CKD were the risk factors affecting the rate of ICU admission, and CKD and ARF were the risk factors affecting the need for invasive ventilation.

摘要

引言

2019年冠状病毒病(COVID-19)已成为对公众健康的一大威胁。患有慢性病(如糖尿病)的人感染这种新疾病后,患重症和死亡的风险更高。由于COVID-19的新颖性,关于糖尿病患者中其死亡率及危险因素的具体信息尚无可用资料。因此,本研究旨在比较糖尿病和非糖尿病COVID-19患者的死亡率、入住重症监护病房(ICU)的需求、有创和无创通气情况以及相关危险因素。

方法

这是一项横断面研究,对2020年3月至2020年9月入住阿瓦士拉齐医院的650例成年COVID-19患者(325例糖尿病患者和325例非糖尿病患者)的病历进行分析。

结果

糖尿病组患者的平均年龄为61.3岁,非糖尿病组为52.3岁。糖尿病组男性占48.3%,非糖尿病组男性占59.7%。与非糖尿病组相比,糖尿病患者患有更多的基础疾病,如缺血性心脏病(IHD)、高血压(HTN)、慢性肾脏病(CKD)和急性肾衰竭(ARF)(<0.0001)。此外,与非糖尿病组相比,糖尿病组的死亡率显著更高(分别为17.5%和12%;=0.047),入住ICU的比例更高(分别为35.4%和27.7%;=0.035),且有创通气的需求更大(分别为17.5%和11.4%;=0.026)。

结论

糖尿病患者的死亡率、入住ICU的需求和有创通气的需求显著高于非糖尿病患者。我们对COVID-19糖尿病患者的逻辑回归分析表明,年龄、CKD和ARF是影响死亡率的危险因素。相比之下,年龄和CKD是影响入住ICU率的危险因素,而CKD和ARF是影响有创通气需求的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76a9/8894661/5291f3fd7786/qmj-2022-0009-g001.jpg

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