Department of Pneumology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania.
Department of Diabetes and Nutrition Diseases, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.
Int J Mol Sci. 2023 Oct 5;24(19):14908. doi: 10.3390/ijms241914908.
Inflammation along with coagulation disturbances has an essential role in the evolution towards a severe disease in patients with the coronavirus disease 2019 (COVID-19). This study aimed to evaluate inflammatory and coagulation biomarkers when predicting the need to visit an intensive care unit (ICU) in diabetes mellitus (DM) patients. In a retrospective study, laboratory parameters were examined for 366 participants: ICU = 90, of which 44 patients had DM and no ICU admittance = 276. The ability of inflammatory and coagulation markers to distinguish the severity of COVID-19 was determined using univariate and multivariate regression analysis. In all patients, lactate dehydrogenase was the only predictor for ICU admittance in the multivariate analysis. In the DM group, the results showed that the interleukin (IL)-6 and neutrophil/lymphocyte ratio (NLR) values at admission could predict the need for ICU admittance. Even though there were significant differences between the ICU and no ICU admittance groups regarding the coagulation markers, they could not predict the severity of the disease in DM patients. The present study showed for the first time that the IL-6 and NLR admission values could predict ICU admittance in DM patients. This finding could help clinicians manage the infection more easily if the COVID-19 pandemic strikes again.
炎症和凝血紊乱在 2019 年冠状病毒病（COVID-19）患者向严重疾病发展中起重要作用。本研究旨在评估炎症和凝血生物标志物在预测糖尿病（DM）患者需要入住重症监护病房（ICU）时的作用。在一项回顾性研究中，对 366 名参与者的实验室参数进行了检查：入住 ICU=90 名，其中 44 名患者患有 DM 且未入住 ICU=276 名。使用单变量和多变量回归分析确定炎症和凝血标志物区分 COVID-19 严重程度的能力。在所有患者中，乳酸脱氢酶是多变量分析中唯一预测入住 ICU 的指标。在 DM 组中，结果表明入院时的白细胞介素（IL）-6 和中性粒细胞/淋巴细胞比值（NLR）值可预测入住 ICU 的需求。尽管 ICU 和无 ICU 入住组之间在凝血标志物方面存在显著差异，但它们不能预测 DM 患者疾病的严重程度。本研究首次表明，入院时的 IL-6 和 NLR 值可预测 DM 患者入住 ICU。如果 COVID-19 再次流行，这一发现可能有助于临床医生更轻松地管理感染。
