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哥伦比亚新冠肺炎重症监护病房住院患者的高血糖、糖尿病和新发糖尿病:一项纵向队列研究的结果

Hyperglycemia, diabetes, and de novo diabetes in patients hospitalized in intensive care units for COVID-19 in Colombia: Results from a longitudinal cohort study.

作者信息

Sprockel John Jaime, Perez Ana Maria, Chamorro Maria Camila, Vergel Jose Alejandro, Espinosa Ximena, Vargas Juan Carlos, Angarita Carlos, Parra Jhon Edinson

机构信息

El Tunal Hospital, Bogota, Cundinamarca, Colombia.

Fundación Universitaria de Ciencias de la Salud, Bogota, Colombia.

出版信息

J Crit Care Med (Targu Mures). 2025 Jul 31;11(3):257-264. doi: 10.2478/jccm-2025-0026. eCollection 2025 Jul.

Abstract

INTRODUCTION

Hyperglycemia and diabetes have been identified as risk factors for severe COVID-19 and death, with a high rate of reported de novo diabetes. We evaluated their incidence and relationship with adverse outcomes in critically ill COVID-19 patients.

METHODS

Prospective single-center longitudinal cohort study in adults hospitalized in intensive care units for confirmed COVID-19. ROC curves for serum glucose and glycated hemoglobin were plotted in relation to 60-day mortality. A Cox proportional hazards model was used to assess the association of diabetes and de novo diabetes with 60-day mortality.

RESULTS

547 patients were included, with a mean age of 59.8 years; 133 (24.3%) had a history of diabetes, and 67 (12.2%) had de novo diabetes. At 60 days, 317 (57.9%) had died. For mortality, the AUC for glucose at admission was 0.55 (95% CI: 0.48 - 0.62) and 0.51 (95% CI: 0.41 - 0.62) for glycated hemoglobin. In the Cox model, diabetes had an HR of 0.888 (95% CI: 0.695 - 1.135, p: 0.344), history of DM had an HR of 0.881 (95% CI: 0.668 - 1.163, p: 0.371), and de novo diabetes had an HR of 0.963 (95% CI: 0.672 - 1.378, p: 0.835).

CONCLUSION

There was a high incidence of de novo diabetes in patients hospitalized in intensive care for COVID-19. Neither hyperglycemia, history of diabetes, nor de novo diabetes were associated with the development of complications or 60-day mortality.

摘要

引言

高血糖和糖尿病已被确定为重症新型冠状病毒肺炎(COVID-19)及死亡的危险因素,新发糖尿病的报告率很高。我们评估了危重症COVID-19患者中高血糖和糖尿病的发生率及其与不良结局的关系。

方法

对入住重症监护病房的确诊COVID-19成年患者进行前瞻性单中心纵向队列研究。绘制血清葡萄糖和糖化血红蛋白与60天死亡率相关的ROC曲线。采用Cox比例风险模型评估糖尿病和新发糖尿病与60天死亡率的关联。

结果

纳入547例患者,平均年龄59.8岁;133例(24.3%)有糖尿病病史,67例(12.2%)为新发糖尿病。60天时,317例(57.9%)死亡。对于死亡率,入院时血糖的AUC为0.55(95%CI:0.48 - 0.62),糖化血红蛋白的AUC为0.51(95%CI:0.41 - 0.62)。在Cox模型中,糖尿病的HR为0.888(95%CI:0.695 - 1.135,p:0.344),糖尿病病史的HR为0.881(95%CI:0.668 - 1.163,p:0.371),新发糖尿病的HR为0.963(95%CI:0.672 - 1.378,p:0.835)。

结论

入住重症监护病房的COVID-19患者中,新发糖尿病的发生率很高。高血糖、糖尿病病史或新发糖尿病均与并发症的发生或60天死亡率无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9aac/12321255/f072d88c0ed1/j_jccm-2025-0026_fig_001.jpg

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