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导致糖尿病患者 COVID-19 预后不良的因素:一项单中心队列研究的结果。

Factors contributing to poor COVID-19 outcomes in diabetic patients: Findings from a single-center cohort study.

机构信息

Department of Physiology and Biochemistry, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

PLoS One. 2023 Aug 31;18(8):e0290946. doi: 10.1371/journal.pone.0290946. eCollection 2023.

Abstract

Diabetes Mellitus (DM) is a frequent comorbidity in patients infected with the SARS-CoV-2 virus. The risk of developing severe or critical COVID-19 and higher mortality was observed to be increased in diabetic patients hospitalized due to COVID-19. In this study we aimed to find out the impact of clinical characteristics, comorbidities, laboratory results, and complications on the outcomes of diabetic patients hospitalized due to COVID-19. This article is a retrospective cohort study that include diabetic patients hospitalized with COVID-19 infection. A definition of diabetes was based on the past history of diabetes or if the HbA1c was 6.5% or higher. Demographics, clinical characteristics, comorbidities, laboratory results, and complications were extracted from the electronic medical records. The mortality rate increased with increasing age (from 5.56% in younger patients to 46% in the elderly) and with severity (from 25.71% in moderate cases to 43.77% in critical cases). We found that a critical severity on admission (OR: 5.26, 95% CI: 1.28-21.66, p = 0.0214), a history of stroke (OR: 8.37, 95% CI: 2.2-31.88, p = 0.0018), and low calcium levels on admission (OR: 2.23, 95% CI: 1.01-4.91, p = 0.0475) were significant risk factors predicting higher COVID-19 mortality in diabetic patients. The findings of this study suggest that reduced calcium levels could potentially indicate higher mortality due to COVID-19 in patients with DM. Furthermore, careful monitoring of diabetic patients hospitalized due to COVID-19 infection, especially those with critical disease severity or those with a history of stroke, may improve their outcome and lessen mortality.

摘要

糖尿病(DM)是感染 SARS-CoV-2 病毒的患者常见的合并症。观察到因 COVID-19 住院的糖尿病患者发生严重或危急 COVID-19 以及更高死亡率的风险增加。在这项研究中,我们旨在了解临床特征、合并症、实验室结果和并发症对因 COVID-19 住院的糖尿病患者结局的影响。本文是一项回顾性队列研究,纳入因 COVID-19 感染住院的糖尿病患者。糖尿病的定义基于过去的糖尿病病史或 HbA1c 为 6.5%或更高。从电子病历中提取人口统计学、临床特征、合并症、实验室结果和并发症。死亡率随年龄增加而增加(从年轻患者的 5.56%到老年患者的 46%),并随严重程度增加而增加(从中度患者的 25.71%到危急患者的 43.77%)。我们发现入院时严重程度危急(OR:5.26,95%CI:1.28-21.66,p=0.0214)、有中风病史(OR:8.37,95%CI:2.2-31.88,p=0.0018)和入院时血钙水平低(OR:2.23,95%CI:1.01-4.91,p=0.0475)是预测糖尿病患者 COVID-19 死亡率较高的显著危险因素。这项研究的结果表明,血钙水平降低可能预示着 COVID-19 导致的糖尿病患者死亡率较高。此外,对因 COVID-19 感染住院的糖尿病患者,特别是那些疾病严重程度危急或有中风病史的患者,进行仔细监测,可能会改善他们的结局并降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6f7/10470961/93cf73c2ade0/pone.0290946.g001.jpg

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