Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Endocrinology, The Affiliated Loudi Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Front Endocrinol (Lausanne). 2023 Aug 14;14:1237832. doi: 10.3389/fendo.2023.1237832. eCollection 2023.
This study aims to describe the clinical characteristics, laboratory data and complications of hospitalized COVID-19 patients with type 2 diabetes mellitus (T2DM) since epidemic prevention and control optimization was adjusted in December 2022 in China.
This retrospective multicenter study included 298 patients with confirmed type 2 diabetes mellitus with or without COVID-19. We collected data from the first wave of the pandemic in The Fifth Affiliated Hospital of Guangzhou Medical University, Loudi Central Hospital and The First People's Hospital of Xiangtan from December 1, 2022 to February 1, 2023. We extracted baseline data, clinical symptoms, acute complications, laboratory findings, treatment and outcome data of each patient from electronic medical records.
For among 298 hospitalized patients with type 2 diabetes, 136 (45.6%) were COVID-19 uninfected, and 162 (54.4%) were COVID-19 infected. We found that the incidence of cough, fatigue, fever, muscle soreness, sore throat, shortness of breath, hyposmia, hypogeusia and polyphagia (all p<0.01) were significantly higher in the exposure group. They showed higher levels of ketone (p=0.04), creatinine (p<0.01), blood potassium (p=0.01) and more diabetic ketoacidosis (p<0.01). Patients with COVID-19 less use of metformin (p<0.01), thiazolidinediones (p<0.01) and SGLT2 (p<0.01) compared with patients without COVID-19.
COVID-19 patients with diabetes showed more severe respiratory and constitutional symptoms and an increased proportion of hyposmia and hypogeusia. Moreover, COVID-19 patients with diabetes have a higher incidence of acute complications, are more prone to worsening renal function, and are more cautious about the use of antidiabetic drugs.
本研究旨在描述 2022 年 12 月中国调整疫情防控优化措施以来，住院 COVID-19 合并 2 型糖尿病（T2DM）患者的临床特征、实验室数据和并发症。
这是一项回顾性多中心研究，纳入了 298 例确诊的 T2DM 合并或不合并 COVID-19 的患者。我们从 2022 年 12 月 1 日至 2023 年 2 月 1 日，从广州医科大学附属第五医院、娄底市中心医院和湘潭市第一人民医院的第一波疫情中收集数据。我们从电子病历中提取每位患者的基线数据、临床症状、急性并发症、实验室检查、治疗和结局数据。
在 298 例住院 T2DM 患者中，136 例（45.6%）未感染 COVID-19，162 例（54.4%）感染 COVID-19。我们发现，暴露组的咳嗽、疲劳、发热、肌肉酸痛、咽痛、呼吸困难、嗅觉减退、味觉减退和多食（均 P<0.01）发生率明显更高。他们的酮体（P=0.04）、肌酐（P<0.01）、血钾（P=0.01）水平更高，且糖尿病酮症酸中毒（DKA）（P<0.01）更多。与未感染 COVID-19 的患者相比，感染 COVID-19 的患者更少使用二甲双胍（P<0.01）、噻唑烷二酮类（P<0.01）和 SGLT2（P<0.01）。
COVID-19 合并糖尿病患者表现出更严重的呼吸道和全身症状，嗅觉减退和味觉减退的比例更高。此外，COVID-19 合并糖尿病患者急性并发症发生率更高，肾功能恶化风险更高，且使用降糖药物更为谨慎。
