Mittal Naveen, Dhooria Harmeet Pal S, Arora Saurabh, Kumar Vipin, Bansal Ekta, Singh Parminder, Kalra Sanjay, Goyal Saloni, Mittal Namit, Naved Khizar, Mohan Bishav
Department of Endocrinology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Indian J Endocrinol Metab. 2022 Jul-Aug;26(4):376-383. doi: 10.4103/ijem.ijem_148_22. Epub 2022 Sep 20.
Diabetes mellitus is associated with poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19). This study aimed to explore the clinical characteristics of patients with type 2 diabetes with COVID-19, and to determine the impact of type 2 diabetes on clinical outcome of patients with COVID-19.
This single-center, retrospective, observational study enrolled patients admitted from March 2020 to June 2021 with COVID-19. The clinical and biochemical characteristics of patients with known type 2 diabetes, newly diagnosed diabetes, type 2 diabetes with comorbidities and those who succumbed to illness were analyzed.
Of 4,559 patients with COVID-19, 2,090 (45.8%) had type 2 diabetes. Patients with COVID-19 with diabetes were older, more likely to receive mechanical ventilation, had higher odds of mortality from COVID-19 as compared with patients without diabetes. In addition, patients with diabetes had significantly higher levels of serum creatinine, C-reactive protein, ferritin, lactate dehydrogenase, and D-dimer. Compared with previously diagnosed patients with diabetes, newly diagnosed patients had higher mortality (33% vs. 27%, P = 0.049). Among patients with COVID-19 and diabetes, nonsurvivors had significantly higher levels of inflammatory markers and had severe impairment of cardiac, renal, and coagulation parameters as opposed to survivors.
Patients with COVID-19 with diabetes were more likely to have severe disease and had higher mortality. Presence of chronic kidney disease and coronary artery disease in patients with diabetes with COVID-19 was associated with adverse outcome. Patients with newly diagnosed diabetes had higher odds of severe disease at presentation and had higher mortality.
2019冠状病毒病(COVID-19)患者中,糖尿病与不良临床结局相关。本研究旨在探讨2型糖尿病合并COVID-19患者的临床特征,并确定2型糖尿病对COVID-19患者临床结局的影响。
本单中心、回顾性、观察性研究纳入了2020年3月至2021年6月收治的COVID-19患者。分析了已知2型糖尿病患者、新诊断糖尿病患者、合并症的2型糖尿病患者以及因病死亡患者的临床和生化特征。
在4559例COVID-19患者中,2090例(45.8%)患有2型糖尿病。与无糖尿病的COVID-19患者相比,合并糖尿病的COVID-19患者年龄更大,更有可能接受机械通气,COVID-19导致的死亡几率更高。此外,糖尿病患者的血清肌酐、C反应蛋白、铁蛋白、乳酸脱氢酶和D-二聚体水平显著更高。与先前诊断的糖尿病患者相比,新诊断的患者死亡率更高(33%对27%,P = 0.049)。在COVID-19合并糖尿病的患者中,与幸存者相比,非幸存者的炎症标志物水平显著更高,心脏、肾脏和凝血参数严重受损。
COVID-19合并糖尿病的患者更易患重症疾病且死亡率更高。COVID-19合并糖尿病患者中存在慢性肾病和冠状动脉疾病与不良结局相关。新诊断糖尿病的患者在就诊时患重症疾病的几率更高且死亡率更高。