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新型冠状病毒肺炎住院患者糖尿病的不同方面

Different Aspects of Diabetes in Hospitalized Patients with COVID-19.

作者信息

Sayed Aml Ahmed, Abdelfatah Hossam Hassan, Abdelhameid Marwa Ahmed, Ali Omaima Mohamed

机构信息

Internal Medicine Department, Faculty of Medicine, Aswan University, Aswan, Egypt.

出版信息

Int J Gen Med. 2022 Jun 21;15:5729-5740. doi: 10.2147/IJGM.S360160. eCollection 2022.

Abstract

BACKGROUND

The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) causes COVID-19, a recent infectious disease that aggravates the underlying pathophysiology of hyperglycemia in diabetic individuals. This study aimed to detect how diabetes mellitus (DM) affected COVID-19 patients' morbidity and mortality, and the incidence of neonset DM.

PATIENTS AND METHODS

The present study was a cross-sectional study done at Aswan Isolation Hospitals, Egypt. It comprised 200 individuals who had been tested positive for COVID-19. They were divided into two groups: group 1 (pre-existing diabetes = 143 patients) and group 2 (new-onset diabetes = 57 patients), and all patients were subjected to general examinations, hospital stay duration, and investigations, such as (complete blood count, urea, creatinine, HBA1c, fasting, postprandial, and random blood sugar, D-Dimer, ferritin, C-reactive protein, PCR for SARS COV-2 RNA, and CT chest.

RESULTS

The current study consisted of 94 males and 106 females. According to disease severity, they were 96 (48.0%) critical cases, 57 (28.5%) severe cases, and 47 (23.5%) non-severe cases. The incidence of new-onset DM in COVID-19 patients was 28.5% (57 new cases), with a mortality rate of 42.0% (84 cases). Regarding glycemic control, we found a significant difference in fasting blood sugar (FBS) between the two groups, with a significant increase of FBS in the dead group than in the survived group. We also found a significant age difference in critical than in severe and non-severe groups, with a high mortality rate in older patients. Inflammatory markers, such as ferritin, CRP, and D-dimer, were higher in critical than in severe and non-severe groups.

CONCLUSION

The prevalence of new-onset DM is significant among hospitalized COVID-19 patients. Older patients were more prone to disease severity with high mortality rate. Inflammatory markers such as CRP and ferritin were significantly related to the COVID-19 severity and outcome.

摘要

背景

新型严重急性呼吸综合征冠状病毒(SARS-CoV-2)引发了2019冠状病毒病(COVID-19),这是一种近期出现的传染病,会加剧糖尿病患者潜在的高血糖病理生理状况。本研究旨在检测糖尿病(DM)如何影响COVID-19患者的发病率和死亡率,以及新发糖尿病的发生率。

患者与方法

本研究是在埃及阿斯旺隔离医院进行的一项横断面研究。研究对象包括200名COVID-19检测呈阳性的个体。他们被分为两组:第1组(既往有糖尿病 = 143例患者)和第2组(新发糖尿病 = 57例患者),所有患者均接受了全身检查、住院时间以及相关检查,如(全血细胞计数、尿素、肌酐、糖化血红蛋白、空腹、餐后及随机血糖、D-二聚体、铁蛋白、C反应蛋白、SARS-CoV-2 RNA的聚合酶链反应以及胸部CT)。

结果

本研究包括94名男性和106名女性。根据疾病严重程度,其中96例(48.0%)为危重症病例,57例(28.5%)为重症病例,47例(23.5%)为非重症病例。COVID-19患者中新发糖尿病的发生率为28.5%(57例新发病例),死亡率为42.0%(84例)。关于血糖控制,我们发现两组之间空腹血糖(FBS)存在显著差异,死亡组的FBS显著高于存活组。我们还发现危重症组与重症和非重症组相比年龄差异显著,老年患者死亡率较高。炎症标志物,如铁蛋白、CRP和D-二聚体,在危重症组中高于重症和非重症组。

结论

住院COVID-19患者中新发糖尿病的患病率较高。老年患者更容易出现疾病严重程度且死亡率高。CRP和铁蛋白等炎症标志物与COVID-19的严重程度和预后显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5eb1/9233513/781b4f43b462/IJGM-15-5729-g0001.jpg

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