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高血糖对 2 型糖尿病合并 COVID-19 患者免疫功能的影响:一项回顾性研究。

Effect of hyperglycemia on the immune function of COVID-19 patients with type 2 diabetes mellitus: a retrospective study.

机构信息

Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

Department of Obstetrics and Gynaecology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

PeerJ. 2022 Dec 16;10:e14570. doi: 10.7717/peerj.14570. eCollection 2022.

Abstract

PURPOSE

To analyze the clinical characteristics and immune function parameters and to explore the effect of hyperglycemia on the immune function in patients with Corona Virus Disease 2019 (COVID-19) with type 2 diabetes mellitus (T2DM).

METHODS

This retrospective study included patients with COVID-19 with T2DM hospitalized in Renmin Hospital of Wuhan University between January 31, 2020, and February 10, 2020. The clinical data were collected and patients were divided into a well-controlled group (blood glucose 3.9-10.0 mmol/L) and a poorly-controlled group (blood glucose >10.0 mmol/L). The differences in routine blood tests, peripheral lymphocyte subsets, humoral immune components, C-reactive protein (CRP) level, and cytokines were compared, and the correlation between blood glucose and immune parameters as well as the severity of the disease was analyzed.

RESULTS

A total of 65 patients with COVID-19 and T2DM were included in the final analysis. Compared with the well-controlled group, patients in the poorly-controlled group had decreased lymphocytes, CD16 56 NK cells, CD3 T cells, CD8 T cells and increased neutrophil percentage, IL-6 levels, CRP levels and serum concentration of IgA. Blood glucose was inversely correlated with CD16 56 NK cells, CD3 T cells, CD4 T cells, and CD8 T cells and positively correlated with IL-6 and CRP levels. There was a positive correlation between blood glucose and the severity of the COVID-19.

CONCLUSION

Hyperglycemia will aggravate the immune dysfunction of COVID-19 patients with T2DM and affect the severity of COVID-19.

摘要

目的

分析 2 型糖尿病合并 2019 年冠状病毒病(COVID-19)患者的临床特征和免疫功能参数,并探讨高血糖对 COVID-19 合并 2 型糖尿病患者免疫功能的影响。

方法

本回顾性研究纳入 2020 年 1 月 31 日至 2 月 10 日期间在武汉大学人民医院住院的 COVID-19 合并 2 型糖尿病患者。收集临床资料,根据血糖控制情况将患者分为血糖控制良好组(血糖 3.9-10.0mmol/L)和血糖控制不佳组(血糖>10.0mmol/L)。比较两组血常规、外周血淋巴细胞亚群、体液免疫成分、C 反应蛋白(CRP)水平和细胞因子的差异,分析血糖与免疫参数及疾病严重程度的相关性。

结果

最终纳入 65 例 COVID-19 合并 2 型糖尿病患者,其中血糖控制不佳组患者的淋巴细胞、CD16 56 NK 细胞、CD3 T 细胞、CD8 T 细胞减少,中性粒细胞百分比、IL-6 水平、CRP 水平和血清 IgA 浓度升高。血糖与 CD16 56 NK 细胞、CD3 T 细胞、CD4 T 细胞、CD8 T 细胞呈负相关,与 IL-6 和 CRP 水平呈正相关。血糖与 COVID-19 严重程度呈正相关。

结论

高血糖会加重 COVID-19 合并 2 型糖尿病患者的免疫功能障碍,影响 COVID-19 的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c64f/10286731/d5f0bce6d54a/peerj-10-14570-g001.jpg

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