Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Centre, New York City, New York, USA.
Department of Surgery, Beth Israel Deaconess Medical Centre and Harvard Medical School, Boston, Massachusetts, USA.
Diabetes Obes Metab. 2024 Nov;26(11):5368-5375. doi: 10.1111/dom.15900. Epub 2024 Sep 2.
The aim was to investigate whether COVID-19 increases new incidence of hypertension (HTN), chronic kidney disease (CKD) and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) up to 40 months post-infection.
Three groups of patients from the Montefiore Health System in the Bronx (1 March 2020 to 1 July 2023) were studied: T1D patients hospitalized for COVID-19 (H-COVID-19, n = 511), T1D patients with COVID-19 but not hospitalized for COVID-19 (NH-COVID-19, n = 306) and T1D patients without a positive COVID-19 test on record (non-COVID-19, n = 1547). COVID-19 patients were those with a positive polymerase-chain-reaction test on record, and non-COVID-19 patients were either tested negative or not tested on record. Cumulative incidences and adjusted hazard ratios (aHR) with 95% confidence intervals (CI) were computed with adjustment for competing risks.
Compared to non-COVID-19 patients, both H-COVID-19 (unadjusted 19.72% vs. 3.14%, p < 0.001; aHR = 7.55 [3.33, 17.06], p < 0.001) and NH-COVID-19 (10.26% vs. 3.14%, p = 0.004; aHR = 5.08 [2.19, 11.78], p < 0.001) patients were more likely to develop new HTN. Compared to non-COVID-19 patients, both H-COVID-19 (11.41% vs. 1.14%, p < 0.001; aHR = 9.76 [4.248, 22.25], p < 0.001) and NH-COVID-19 (7.69% vs. 1.14%, p < 0.001; aHR = 6.54 [2.91, 14.67], p < 0.001) patients were more likely to develop new CKD. Compared to non-COVID-19 patients, both H-COVID-19 (4.09% vs. 1.06%, p < 0.001; aHR = 12.24 [4.09, 36.59], p < 0.001) and NH-COVID-19 (3.06% vs. 1.06%, p = 0.035; aHR = 12.94 [4.09, 40.89], p < 0.001) patients were more likely to develop new DKA at follow-up.
T1D patients with COVID-19 are at higher risk of developing new HTN, CKD and DKA compared to T1D patients without COVID-19.
本研究旨在探讨 COVID-19 是否会增加 1 型糖尿病（T1D）患者在感染后 40 个月内新发高血压（HTN）、慢性肾脏病（CKD）和糖尿病酮症酸中毒（DKA）的发病率。
本研究纳入了来自布朗克斯蒙特菲奥雷健康系统的三组患者：因 COVID-19 住院的 T1D 患者（H-COVID-19，n=511）、因 COVID-19 但未住院的 T1D 患者（NH-COVID-19，n=306）和无阳性 COVID-19 检测记录的 T1D 患者（非 COVID-19，n=1547）。COVID-19 患者为有阳性聚合酶链反应检测记录的患者，而非 COVID-19 患者要么检测结果为阴性，要么无记录。采用竞争风险调整计算累积发病率和调整后的危险比（aHR）及其 95%置信区间（CI）。
与非 COVID-19 患者相比，H-COVID-19（未经调整的发病率为 19.72% vs. 3.14%，p<0.001；aHR=7.55[3.33, 17.06]，p<0.001）和 NH-COVID-19（10.26% vs. 3.14%，p=0.004；aHR=5.08[2.19, 11.78]，p<0.001）患者更易新发 HTN。与非 COVID-19 患者相比，H-COVID-19（11.41% vs. 1.14%，p<0.001；aHR=9.76[4.248, 22.25]，p<0.001）和 NH-COVID-19（7.69% vs. 1.14%，p<0.001；aHR=6.54[2.91, 14.67]，p<0.001）患者更易新发 CKD。与非 COVID-19 患者相比，H-COVID-19（4.09% vs. 1.06%，p<0.001；aHR=12.24[4.09, 36.59]，p<0.001）和 NH-COVID-19（3.06% vs. 1.06%，p=0.035；aHR=12.94[4.09, 40.89]，p<0.001）患者更易新发 DKA。
与无 COVID-19 的 T1D 患者相比，COVID-19 患者新发 HTN、CKD 和 DKA 的风险更高。
