在中国一家三级医院小规模新冠疫情爆发期间收治的住院新冠患者中，糖尿病与不良结局的相关性
Correlation of diabetes and adverse outcomes in hospitalized COVID-19 patients admitted to a tertiary hospital in China during a small-scale COVID-19 outbreak.
作者信息
Li Yu, Li Guanni, Li Jiahong, Luo Zirui, Lin Yaxuan, Lan Ning, Zhang Xiaodan
机构信息
Department of Endocrinology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
The Second Clinical Medicine School, Guangzhou Medical University, Guangzhou, China.
出版信息
PeerJ. 2025 Jan 27;13:e18865. doi: 10.7717/peerj.18865. eCollection 2025.
BACKGROUND
The aim of this study was to investigate the impact of diabetes on mortality and adverse outcomes in COVID-19 patients and to analyse the associated risk factors.
METHODS
This is a retrospective cohort study in 500 hospitalized patients with COVID-19 infection (214 with diabetes and 286 without diabetes) admitted to a tertiary hospital in China from December 2022 to February 2023. Demographic information, clinical characteristics and outcomes were collected. Survival status was investigated at discharge and at 6 months after discharge.
RESULTS
The mortality rate of COVID-19 patients with diabetes was higher than the rate of non-diabetic COVID-19 patients, both at discharge, and at 6 months after discharge. Body mass index (BMI), C-reactive protein (CRP), pH, D-dimer, blood osmotic pressure, serum creatinine, white blood cell count, creatine kinase and hospitalization expenses were significantly different between diabetic group and non-diabetic group ( < 0.05). Compared with the survivors, non-survived COVID-19 patients with diabetes had worse diabetes control indicators, with random blood glucose increased by 3.58 mmol/L ( < 0.05), and fasting blood glucose increased by 2.77 mmol/L ( < 0.01). In addition, there were significant differences in age, heart rate, CRP, pH, potassium (K), serum creatinine, white blood cell count, creatine kinase, the proportion with diabetic complications, treatment in ICU and mechanical ventilation between survivors and non-survivors of COVID-19 patients with diabetes. By multivariate logistic regression analysis, the death of COVID-19 patients with diabetes is positively correlated with age and CRP ( < 0.05), and has a trend towards significance with fasting blood glucose ( < 0.1).
CONCLUSION
Infection with COVID-19 on the basis of diabetes can significantly increase mortality, which was further associated with diabetes control indicators.
背景
本研究旨在调查糖尿病对新型冠状病毒肺炎（COVID-19）患者死亡率和不良结局的影响，并分析相关危险因素。
方法
这是一项回顾性队列研究，研究对象为2022年12月至2023年2月在中国一家三级医院收治的500例COVID-19感染住院患者（214例患有糖尿病，286例未患糖尿病）。收集了人口统计学信息、临床特征和结局。在出院时和出院后6个月调查生存状况。
结果
COVID-19糖尿病患者的死亡率在出院时和出院后6个月均高于非糖尿病COVID-19患者。糖尿病组和非糖尿病组之间的体重指数（BMI）、C反应蛋白（CRP）、pH值、D-二聚体、血液渗透压、血清肌酐、白细胞计数、肌酸激酶和住院费用存在显著差异（P<0.05）。与幸存者相比，未存活的COVID-19糖尿病患者的血糖控制指标更差，随机血糖升高3.58 mmol/L（P<0.05），空腹血糖升高2.77 mmol/L（P<0.01）。此外，COVID-19糖尿病患者的幸存者和非幸存者在年龄、心率、CRP、pH值、钾（K）、血清肌酐、白细胞计数、肌酸激酶、糖尿病并发症比例、重症监护病房（ICU）治疗和机械通气方面存在显著差异。通过多因素logistic回归分析，COVID-19糖尿病患者的死亡与年龄和CRP呈正相关（P<0.05），与空腹血糖有显著相关趋势（P<0.1）。
结论
在糖尿病基础上感染COVID-19可显著增加死亡率，这与血糖控制指标进一步相关。
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