Dei Cas Alessandra, Aldigeri Raffaella, Eletto Elisa, Ticinesi Andrea, Nouvenne Antonio, Prati Beatrice, Vazzana Angela, Antonini Monica, Moretti Valentina, Balestreri Emanuela, Spigoni Valentina, Fantuzzi Federica, Schirò Silvia, Ruffini Livia, Sverzellati Nicola, Meschi Tiziana, Bonadonna Riccardo
Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria of Parma, Via Gramsci 14, 43126, Parma, Italy.
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Acta Diabetol. 2025 May 2. doi: 10.1007/s00592-025-02507-1.
Diabetes mellitus (DM) and hyperglycemia are associated with poor outcome(s) in COVID-19 hospitalized patients, but their independent impact on prognosis remains unclear. We aimed to assess the impact of DM and hyperglycemia on COVID-19 outcomes.
Clinical data/records from COVID-19 patients admitted to the Parma University-Hospital (February 23rd to March 31st, 2020) were retrieved and analysed (NCT04550403). Fasting plasma glucose (FPG), inflammatory markers and the main biochemical variables were collected at admission. Patients underwent chest high-resolution CT and arterial blood gas analysis to determine the PaO/FiO ratio (P/F ratio). The primary outcome was a composite of intensive care unit admission and/or death.
Among 756 subjects, 143 (19%) had DM. These patients were older with higher comorbidity rates. The primary outcome occurred in 61.5% DM patients versus 43.4% without DM (p < 0.001). In multivariable analysis (accuracy UC = 0.93), older age, cardiovascular and kidney diseases, FPG ≥ 126 mg/dl, C-reactive protein, and P/F ratio, but not previous DM, were independent risk indicators.
DM indicated poor COVID-19 outcomes, but not when adjusted for other clinical variables/comorbities, suggesting that its impact was mostly driven by concomitant factors. The independent role of fasting hyperglycemia points to the need for further research on its contribution to COVID-19.
糖尿病（DM）和高血糖与COVID-19住院患者的不良预后相关，但其对预后的独立影响尚不清楚。我们旨在评估DM和高血糖对COVID-19预后的影响。
检索并分析了帕尔马大学医院（2020年2月23日至3月31日）收治的COVID-19患者的临床数据/记录（NCT04550403）。入院时收集空腹血糖（FPG）、炎症标志物和主要生化变量。患者接受胸部高分辨率CT和动脉血气分析以确定PaO/FiO比值（P/F比值）。主要结局是重症监护病房入院和/或死亡的综合情况。
在756名受试者中，143名（19%）患有DM。这些患者年龄较大，合并症发生率较高。主要结局在61.5%的DM患者中出现，而无DM患者中为43.4%（p<0.001）。在多变量分析中（准确性UC=0.93），年龄较大、心血管和肾脏疾病、FPG≥126mg/dl、C反应蛋白和P/F比值，但不是既往DM，是独立的风险指标。
DM表明COVID-19预后不良，但在调整其他临床变量/合并症后并非如此，这表明其影响主要由伴随因素驱动。空腹高血糖的独立作用表明需要进一步研究其对COVID-19的影响。
