Department of Internal Medicine, Ayancik Government Hospital, Sinop, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Jun;26(11):4117-4122. doi: 10.26355/eurrev_202206_28982.
Most patients with a severe COVID-19 infection have underlying diseases such as hypertension, cardiovascular disorders, and diabetes, and the mortality rate in these patients is higher than in other patients. Reasonable glycemic control is a practical approach to prevent the progression of COVID-19 in patients with diabetes. In this study, we aimed at demonstrating that glycemic control status can be used as a biomarker in predicting the severity of the disease in the early period in diabetic patients with COVID-19.
Our retrospective study consisted of 122 patients who referred to Sinop Ayancik State Hospital between April 1, 2020, and April 1, 2021. 40 diabetic patients with poor glycemic control (HbA1C above 7), 40 diabetic patients with reasonable glycemic control (HgA1c below 7), and 42 patients without diabetes were included in the study. The patients' data included in the study were obtained by scanning the retrospective files. These patients' demographic characteristics, clinical features, age, gender, length of stay, hemogram, biochemical, hormonal parameters, HgA1c levels, and atherogenic indexes were calculated and recorded. Study groups were compared in terms of disease severity and mortality.
A statistically significant difference was found between mild/severe conditions (p-value < 0.001). 72.5% of those with poor glycemic control, 57.5% of those with reasonable glycemic control, and 26.2% without diabetes had severe diseases. Also, a statistically significant difference was found between the distributions of death rate (p = 0.008). 17.5% of those with poor glycemic control, 5% of those with reasonable glycemic control, and 0% of patients without diabetes died.
Our results showed that poor glycemic control was an effective indicator of disease severity and mortality in patients with COVID-19 and could predict disease progression and mortality.
大多数患有严重 COVID-19 感染的患者都有高血压、心血管疾病和糖尿病等基础疾病，这些患者的死亡率高于其他患者。合理的血糖控制是预防 COVID-19 患者疾病进展的实用方法。在这项研究中，我们旨在证明血糖控制状态可以用作预测 COVID-19 糖尿病患者疾病严重程度的早期生物标志物。
我们的回顾性研究包括 2020 年 4 月 1 日至 2021 年 4 月 1 日期间到 Sinop Ayancik 州立医院就诊的 122 名患者。40 名血糖控制不佳的糖尿病患者（HbA1C 高于 7）、40 名血糖控制合理的糖尿病患者（HgA1c 低于 7）和 42 名无糖尿病患者纳入研究。研究中患者的数据通过扫描回顾性文件获得。这些患者的人口统计学特征、临床特征、年龄、性别、住院时间、血象、生化、激素参数、HgA1c 水平和致动脉粥样硬化指数均进行了计算和记录。比较了各组疾病严重程度和死亡率。
血糖控制不佳组与血糖控制合理组之间的疾病严重程度（p 值<0.001）有统计学显著差异。血糖控制不佳组中 72.5%、血糖控制合理组中 57.5%和无糖尿病组中 26.2%的患者病情严重。死亡率分布也有统计学显著差异（p=0.008）。血糖控制不佳组中 17.5%、血糖控制合理组中 5%和无糖尿病组中 0%的患者死亡。
我们的结果表明，血糖控制不佳是 COVID-19 患者疾病严重程度和死亡率的有效指标，可以预测疾病进展和死亡率。
