Făgărășan Iulia, Rusu Adriana, Comșa Horațiu, Cristea Maria, Motoc Nicoleta-Ștefania, Cristea Ciprian, Budin Corina Eugenia, Râjnoveanu Ruxandra-Mioara, Todea Doina Adina
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.
J Clin Med. 2024 Dec 22;13(24):7832. doi: 10.3390/jcm13247832.
The mortality rate from community-acquired pneumonia (CAP) or coronavirus disease 19 (COVID-19) is high, especially in hospitalized patients. This study aimed to assess the disturbances of glucose and lipid metabolism with in-hospital complications and short-term outcomes for patients with pneumonia with different etiologies. This observational study comprised 398 patients divided as follows: 155 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, 129 participants with viral CAP, and 114 with bacterial pneumonia. Fasting plasma glucose (FPG) at admission and glycemic variation during hospitalization was linked with acute kidney injury (AKI) in bacterial CAP. Compared with a value <110 mg/dL for FPG at admission, levels between 110 and 126 mg/dL are associated with mortality in both COVID-19 (OR = 3.462, 95% CI: 1.275-9.398, = 0.015) and bacterial CAP participants (OR = 0.254; 95% CI: 0.069-0.935, = 0.039), while a value ≥126 mg/dL was linked with mortality only in patients with SARS-CoV-2 (OR = 3.577, 95% CI: 1.166-10.976, = 0.026). No relation between lipid biomarkers and complications or in-hospital outcomes was observed in all three participant groups. Patients with bacterial CAP are more prone to developing AKI due to increased FBG at admission and glycemic variations during hospitalization, while elevated FBG values at admission are associated with mortality in both COVID-19 and bacterial CAP.
社区获得性肺炎（CAP）或冠状病毒病19（COVID-19）的死亡率很高，尤其是在住院患者中。本研究旨在评估不同病因肺炎患者的血糖和脂质代谢紊乱与院内并发症及短期预后的关系。这项观察性研究纳入了398例患者，分组如下：155例严重急性呼吸综合征冠状病毒2（SARS-CoV-2）肺炎患者、129例病毒性CAP参与者和114例细菌性肺炎患者。入院时的空腹血糖（FPG）及住院期间的血糖变化与细菌性CAP患者的急性肾损伤（AKI）相关。与入院时FPG<110 mg/dL相比，110至126 mg/dL的水平与COVID-19患者（OR = 3.462，95%CI：1.275 - 9.398，P = 0.015）和细菌性CAP参与者的死亡率均相关（OR = 0.254；95%CI：0.069 - 0.935，P = 0.039），而≥126 mg/dL的值仅与SARS-CoV-2患者的死亡率相关（OR = 3.577，95%CI：1.166 - 10.976，P = 0.026）。在所有三个参与者组中均未观察到脂质生物标志物与并发症或院内结局之间的关系。细菌性CAP患者因入院时空腹血糖升高及住院期间血糖变化而更容易发生AKI，而入院时空腹血糖升高与COVID-19和细菌性CAP患者的死亡率均相关。
