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2019冠状病毒病感染糖尿病患者的临床特征与转归:一项纳入192,693例患者的系统评价与Meta分析

The clinical features and outcomes of diabetes patients infected with COVID-19: a systematic review and meta-analysis comprising 192,693 patients.

作者信息

Liu Kai, Liu Shu, Xu Ting-Ting, Qiao Hong

机构信息

Department of Endocrinology and Metabolism, The Second Affifiliated Hospital of Harbin Medical University, Harbin, China.

Physical Examination Center, The Fourth Affifiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Front Med (Lausanne). 2025 Jan 29;12:1523139. doi: 10.3389/fmed.2025.1523139. eCollection 2025.

Abstract

OBJECTIVES

We sought to explore the relevance of analyses that include critical laboratory parameters and drug treatment, clinical characteristics of diabetic patients who are infected with COVID-19, to the development of individualized treatment strategies for diabetic patients infected with COVID-19.

METHODS

We searched Cochrane, Embase, FMRS, Pubmed, Springer, Web of Science databases for systematic reviews and meta-analyses to estimate the clinical characteristics and prognosis of confirmed covid-19 infections in patients with and without diabetes.

RESULTS

Our meta-analysis included a total of 32 studies with 192,693 COVID-19 patients. Common comorbidities in the diabetic group were hypertension, cerebrovascular disease, chronic kidney disease and cardiovascular disease. We discovered that white blood cell count, neutrophil count, inflammatory marker levels, D-dimer, urea, precursor of the brain natriuretic peptide (Pro-BNP) increased and lymphocyte count, estimated glomerular filtration rate (eGFR), albumin decreased significantly in the diabetic group in laboratory test results. Compared with the non-diabetic group, the diabetic group had a higher incidence of complications in acute respiratory distress syndrome (ARDS), shock, acute heart injury, acute kidney injury and more regularly used oxygen therapy, invasive ventilation, non-invasive ventilation, continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO) treatment. Mortality and intensive care unit (ICU) hospitalization rates were highest in the diabetic group than in the non-diabetic group ( < 0.05).

CONCLUSION

Diabetic patients hospitalized with COVID-19 have an increased risk of death, lower discharge rates, and higher ICU admission rates. Their presence of hypertension, cerebrovascular disease, chronic kidney disease (CKD), higher levels of inflammatory markers. Multiple complications are all predictors of poor outcomes in people with diabetes. Our findings will help identify elevated risk factors in diabetics, which will benefit early prediction.

摘要

目的

我们试图探讨包含关键实验室参数和药物治疗的分析与2019冠状病毒病(COVID-19)感染的糖尿病患者的临床特征之间的相关性,以制定针对感染COVID-19的糖尿病患者的个体化治疗策略。

方法

我们检索了Cochrane、Embase、FMRS、Pubmed、Springer、Web of Science数据库,以获取系统评价和荟萃分析,以估计糖尿病患者和非糖尿病患者确诊COVID-19感染的临床特征和预后。

结果

我们的荟萃分析共纳入32项研究,涉及192,693例COVID-19患者。糖尿病组常见的合并症有高血压、脑血管疾病、慢性肾脏病和心血管疾病。我们发现,实验室检查结果显示,糖尿病组白细胞计数、中性粒细胞计数、炎症标志物水平、D-二聚体、尿素、脑钠肽前体(Pro-BNP)升高,淋巴细胞计数、估计肾小球滤过率(eGFR)、白蛋白显著降低。与非糖尿病组相比,糖尿病组急性呼吸窘迫综合征(ARDS)、休克、急性心脏损伤、急性肾损伤的并发症发生率更高,且更常使用氧疗、有创通气、无创通气、持续肾脏替代疗法(CRRT)、体外膜肺氧合(ECMO)治疗。糖尿病组的死亡率和重症监护病房(ICU)住院率高于非糖尿病组(P<0.05)。

结论

因COVID-19住院的糖尿病患者死亡风险增加,出院率降低,ICU入院率更高。他们患有高血压、脑血管疾病、慢性肾脏病(CKD)、炎症标志物水平较高。多种并发症都是糖尿病患者预后不良的预测因素。我们的研究结果将有助于识别糖尿病患者中升高的危险因素,这将有助于早期预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53d9/11813781/e0b35eb428e3/fmed-12-1523139-g001.jpg

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