Tyrer Freya, Gharibzadeh Safoora, Gillies Clare, Lawson Claire, Routen Ash, Islam Nazrul, Razieh Cameron, Zaccardi Francesco, Yates Tom, Davies Melanie J, Brightling Christopher E, Chalmers James D, Docherty Annemarie B, Elneima Omer, Evans Rachael A, Greening Neil J, Harris Victoria C, Harrison Ewen M, Ho Ling-Pei, Horsley Alex, Houchen-Wolloff Linzy, Leavy Olivia C, Lone Nazir I, Marks Michael, McAuley Hamish J C, Poinasamy Krisnah, Quint Jennifer K, Raman Betty, Richardson Matthew, Saunders Ruth, Sereno Marco, Shikotra Aarti, Singapuri Amish, Wain Louise V, Khunti Kamlesh
Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
Centre for Ethnic Health, Diabetes Research Centre, University of Leicester, Leicester, UK.
Diabetes Obes Metab. 2025 Feb;27(2):767-776. doi: 10.1111/dom.16071. Epub 2024 Nov 20.
People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness.
We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19. Individuals were included if they attended at least one research visit with a HbA1c measurement within 14 months of discharge and had no history of diabetes at baseline. The primary outcome was new onset diabetes (any type), as defined by a first glycated haemoglobin (HbA1c) measurement ≥6.5% (≥48 mmol/mol). Follow-up was censored at the last HbA1c measurement. Age-standardised incidence rates and incidence rate ratios (adjusted for age, sex, ethnicity, length of hospital stay, body mass index, smoking, physical activity, deprivation, hypertension, hyperlipidaemia/hypercholesterolaemia, intensive therapy unit admission, invasive mechanical ventilation, corticosteroid use and C-reactive protein score) were calculated using Poisson regression. Incidence rates were compared with the control groups of published clinical trials in the United Kingdom by applying the same inclusion and exclusion criteria, where possible.
Incidence of diabetes was 91.4 per 1000 person-years and was higher in South Asian (incidence rate ratios [IRR] = 3.60; 1.77, 7.32; p < 0.001) and Black ethnic groups (IRR = 2.36; 1.07, 5.21; p = 0.03) compared with White ethnic groups. When restricted to similar characteristics, the incidence rates were similar to those in UK clinical trials data.
Diabetes incidence following hospitalisation for COVID-19 is high, but it remains uncertain whether it is disproportionately higher than pre-pandemic levels.
因2019冠状病毒病（COVID-19）住院的患者患糖尿病的发生率升高。然而，尚不清楚这是由于共同的风险因素、混杂因素还是对急性疾病的应激性高血糖所致。
我们分析了一项多中心前瞻性队列研究（PHOSP-COVID），研究对象为在英国国民保健服务（NHS）医院因COVID-19出院的18岁及以上人群。如果个体在出院后14个月内至少参加了一次有糖化血红蛋白（HbA1c）测量的研究访视，且基线时无糖尿病史，则纳入研究。主要结局是新发糖尿病（任何类型），定义为首次糖化血红蛋白（HbA1c）测量值≥6.5%（≥48 mmol/mol）。随访在最后一次HbA1c测量时截尾。使用泊松回归计算年龄标准化发病率和发病率比（根据年龄、性别、种族、住院时间、体重指数、吸烟、体力活动、贫困程度、高血压、高脂血症/高胆固醇血症、重症监护病房入住、有创机械通气、使用皮质类固醇和C反应蛋白评分进行调整）。在可能的情况下，通过应用相同的纳入和排除标准，将发病率与英国已发表的临床试验对照组进行比较。
糖尿病发病率为每1000人年91.4例，与白人种族相比，南亚（发病率比[IRR]=3.60；1.77，7.32；p<0.001）和黑人种族（IRR=2.36；1.07，5.21；p=0.03）的发病率更高。当限制在相似特征时，发病率与英国临床试验数据中的发病率相似。
COVID-19住院后的糖尿病发病率很高，但仍不确定它是否比大流行前水平高得不成比例。
