Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Endocrinol Diabetes Metab. 2023 Nov;6(6):e454. doi: 10.1002/edm2.454. Epub 2023 Oct 9.
To determine association between diabetes in confirmed cases of COVID-19 and intensive care admission and in-hospital mortality, evaluate several laboratory parameters as mortality predictor and develop predictors of in-hospital mortality among diabetics with COVID-19.
This retrospective cohort recruited all cases of COVID-19 hospitalized in Fatmawati General Hospital from March to October 2020. Inclusion criterion was RT-PCR confirmed cases of COVID-19 who aged 18 years and older while exclusion criteria were incomplete medical record or cannot be found and pregnant women.
We enrolled 506 participants to this study with median age of 51 years (IQR:22), female (56.32%), and diabetes (28.46%). Diabetes increased intensive care admission (adjusted OR: 2.57; 95% CI: 3.52-10.43) and in-hospital mortality (adjusted OR: 2.50; 95% CI: 1.61-3.89). In predicting in-hospital mortality, ferritin and lactate dehydrogenase offered an acceptable discrimination, AUC: 0.71 (95% CI: 0.62-0.79) and AUC: 0.70 (95% CI: 0.61-0.78), respectively. The optimal cut-off of predicting mortality for ferritin was 786 g/mL and for LDH was 514.94 u/L. Factors include age above 70 years old, RBGs level on admission above 250 mg/dL or below 140 mg/dL, ferritin level above 786 ng/mL and presence of ARDS increased the odds of mortality among individuals with diabetes.
Diabetes increases risk intensive care admission and in hospital mortality in COVID-19. Multivariate analysis showed that older age, RBG on admission, high ferritin level, presence of ARDS increased the odds of mortality among individuals with diabetes.
确定确诊 COVID-19 病例中糖尿病与重症监护入院和住院死亡率之间的关系，评估几种实验室参数作为死亡率预测指标，并为 COVID-19 糖尿病患者制定住院死亡率预测指标。
本回顾性队列研究纳入 2020 年 3 月至 10 月期间在法玛瓦蒂综合医院住院的所有 COVID-19 病例。纳入标准为经 RT-PCR 确诊的年龄在 18 岁及以上的 COVID-19 病例，排除标准为病历不完整或无法找到以及孕妇。
本研究共纳入 506 名参与者，中位年龄为 51 岁（IQR：22），女性（56.32%），糖尿病（28.46%）。糖尿病增加了重症监护病房收治（调整后的 OR：2.57；95%CI：3.52-10.43）和住院死亡率（调整后的 OR：2.50；95%CI：1.61-3.89）。在预测住院死亡率方面，铁蛋白和乳酸脱氢酶提供了可接受的区分度，AUC：0.71（95%CI：0.62-0.79）和 AUC：0.70（95%CI：0.61-0.78）。预测死亡率的铁蛋白最佳截断值为 786ng/mL，乳酸脱氢酶为 514.94u/L。年龄大于 70 岁、入院时 RBG 水平高于 250mg/dL 或低于 140mg/dL、铁蛋白水平高于 786ng/mL 以及存在 ARDS 均增加了糖尿病患者死亡的可能性。
糖尿病增加 COVID-19 患者重症监护病房收治和住院死亡率的风险。多变量分析显示，年龄较大、入院时 RBG、铁蛋白水平升高、ARDS 存在增加了糖尿病患者死亡的可能性。
