Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, P. R. China.
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China.
Epidemiol Infect. 2022 May 16;150:e106. doi: 10.1017/S095026882200022X.
This study is performed to figure out how the presence of diabetes affects the infection, progression and prognosis of 2019 novel coronavirus disease (COVID-19), and the effective therapy that can treat the diabetes-complicated patients with COVID-19. A multicentre study was performed in four hospitals. COVID-19 patients with diabetes mellitus (DM) or hyperglycaemia were compared with those without these conditions and matched by propensity score matching for their clinical progress and outcome. Totally, 2444 confirmed COVID-19 patients were recruited, from whom 336 had DM. Compared to 1344 non-DM patients with age and sex matched, DM-COVID-19 patients had significantly higher rates of intensive care unit entrance (12.43% vs. 6.58%, P = 0.014), kidney failure (9.20% vs. 4.05%, P = 0.027) and mortality (25.00% vs. 18.15%, P < 0.001). Age and sex-stratified comparison revealed increased susceptibility to COVID-19 only from females with DM. For either non-DM or DM group, hyperglycaemia was associated with adverse outcomes, featured by higher rates of severe pneumonia and mortality, in comparison with non-hyperglycaemia. This was accompanied by significantly altered laboratory indicators including lymphocyte and neutrophil percentage, C-reactive protein and urea nitrogen level, all with correlation coefficients >0.35. Both diabetes and hyperglycaemia were independently associated with adverse prognosis of COVID-19, with hazard ratios of 10.41 and 3.58, respectively.
这项研究旨在探讨糖尿病的存在如何影响 2019 年新型冠状病毒病（COVID-19）的感染、进展和预后，以及治疗 COVID-19 合并糖尿病患者的有效疗法。在四家医院进行了一项多中心研究。将糖尿病（DM）或高血糖的 COVID-19 患者与无这些情况的患者进行比较，并通过倾向评分匹配来比较他们的临床进展和结局。共纳入 2444 例确诊的 COVID-19 患者，其中 336 例患有 DM。与年龄和性别匹配的 1344 例非 DM 患者相比，DM-COVID-19 患者入住重症监护病房的比例明显更高（12.43%比 6.58%，P = 0.014）、肾衰竭（9.20%比 4.05%，P = 0.027）和死亡率（25.00%比 18.15%，P<0.001）。按年龄和性别分层比较发现，只有患有 DM 的女性对 COVID-19 的易感性增加。对于非 DM 或 DM 组，与非高血糖组相比，高血糖与不良结局相关，表现为严重肺炎和死亡率较高。这伴随着明显改变的实验室指标，包括淋巴细胞和中性粒细胞百分比、C 反应蛋白和尿素氮水平，所有这些指标的相关系数均>0.35。糖尿病和高血糖均与 COVID-19 的不良预后独立相关，风险比分别为 10.41 和 3.58。
