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新冠后综合征与糖尿病:国际 HOPE-II COVID-19 注册研究的倾向评分匹配分析。

Post-COVID-19 syndrome and diabetes mellitus: a propensity-matched analysis of the International HOPE-II COVID-19 Registry.

机构信息

Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany.

出版信息

Front Endocrinol (Lausanne). 2023 May 16;14:1167087. doi: 10.3389/fendo.2023.1167087. eCollection 2023.

Abstract

BACKGROUND

Diabetes mellitus (DM) is one of the most frequent comorbidities in patients suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with a higher rate of severe course of coronavirus disease (COVID-19). However, data about post-COVID-19 syndrome (PCS) in patients with DM are limited.

METHODS

This multicenter, propensity score-matched study compared long-term follow-up data about cardiovascular, neuropsychiatric, respiratory, gastrointestinal, and other symptoms in 8,719 patients with DM to those without DM. The 1:1 propensity score matching (PSM) according to age and sex resulted in 1,548 matched pairs.

RESULTS

Diabetics and nondiabetics had a mean age of 72.6 ± 12.7 years old. At follow-up, cardiovascular symptoms such as dyspnea and increased resting heart rate occurred less in patients with DM (13.2% vs. 16.4%; = 0.01) than those without DM (2.8% vs. 5.6%; = 0.05), respectively. The incidence of newly diagnosed arterial hypertension was slightly lower in DM patients as compared to non-DM patients (0.5% vs. 1.6%; = 0.18). Abnormal spirometry was observed more in patients with DM than those without DM (18.8% vs. 13; = 0.24). Paranoia was diagnosed more frequently in patients with DM than in non-DM patients at follow-up time (4% vs. 1.2%; = 0.009). The incidence of newly diagnosed renal insufficiency was higher in patients suffering from DM as compared to patients without DM (4.8% vs. 2.6%; = 0.09). The rate of readmission was comparable in patients with and without DM (19.7% vs. 18.3%; = 0.61). The reinfection rate with COVID-19 was comparable in both groups (2.9% in diabetics vs. 2.3% in nondiabetics; = 0.55). Long-term mortality was higher in DM patients than in non-DM patients (33.9% vs. 29.1%; = 0.005).

CONCLUSIONS

The mortality rate was higher in patients with DM type II as compared to those without DM. Readmission and reinfection rates with COVID-19 were comparable in both groups. The incidence of cardiovascular symptoms was higher in patients without DM.

摘要

背景

糖尿病(DM)是严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染患者最常见的合并症之一,其冠状病毒疾病(COVID-19)的严重程度更高。然而,关于糖尿病患者的 COVID-19 后综合征(PCS)的数据有限。

方法

这项多中心、倾向评分匹配研究比较了 8719 例糖尿病患者和非糖尿病患者的长期随访数据,比较了心血管、神经精神、呼吸、胃肠道和其他症状。根据年龄和性别进行的 1:1 倾向评分匹配(PSM)产生了 1548 对匹配对。

结果

糖尿病患者和非糖尿病患者的平均年龄为 72.6 ± 12.7 岁。在随访中,糖尿病患者的心血管症状(如呼吸困难和静息心率增加)发生率低于非糖尿病患者(13.2% vs. 16.4%;=0.01)。与非糖尿病患者相比,糖尿病患者新发动脉高血压的发生率略低(0.5% vs. 1.6%;=0.18)。与非糖尿病患者相比,糖尿病患者的肺功能检查异常更为常见(18.8% vs. 13%;=0.24)。在随访时,糖尿病患者被诊断为偏执的比例高于非糖尿病患者(4% vs. 1.2%;=0.009)。与非糖尿病患者相比,糖尿病患者新发肾功能不全的发生率更高(4.8% vs. 2.6%;=0.09)。糖尿病患者和非糖尿病患者的再入院率相当(19.7% vs. 18.3%;=0.61)。两组 COVID-19 再感染率相当(糖尿病患者 2.9%,非糖尿病患者 2.3%;=0.55)。与非糖尿病患者相比,糖尿病患者的长期死亡率更高(33.9% vs. 29.1%;=0.005)。

结论

与非糖尿病患者相比,Ⅱ型糖尿病患者的死亡率更高。两组 COVID-19 的再入院率和再感染率相当。非糖尿病患者心血管症状的发生率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/126e/10227507/7c808379348e/fendo-14-1167087-g001.jpg

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