Type 2 Diabetes and COVID-19-Related Mortality in the Critical Care Setting: A National Cohort Study in England, March-July 2020.
Type 2 Diabetes and COVID-19-Related Mortality in the Critical Care Setting: A National Cohort Study in England, March-July 2020.
复制标题
DOI：
10.2337/dc20-1444
复制
发表时间：
2021-01
期刊：
影响因子：
16.2
通讯作者：
Vollmer SJ
中科院分区：
文献类型：
--
作者：
Dennis JM;Mateen BA;Sonabend R;Thomas NJ;Patel KA;Hattersley AT;Denaxas S;McGovern AP;Vollmer SJ
描述重症监护环境中2型糖尿病与2019冠状病毒病（COVID-19）成人全因死亡率之间的关系。这是一项全国性的回顾性队列研究，研究对象为2020年3月1日至2020年7月27日期间因COVID-19在英格兰入院并需要入住高依赖病房（HDU）或重症监护病房（ICU）的患者。采用考克斯比例风险模型估计与2型糖尿病相关的30天住院全因死亡率，并对年龄、性别、种族、肥胖和其他主要合并症（慢性呼吸系统疾病、哮喘、慢性心脏病、高血压、免疫抑制、慢性神经系统疾病、慢性肾脏疾病和慢性肝脏疾病）进行校正。共有19，256例与COVID-19相关的HDU和ICU入院纳入主要分析，包括13，809例HDU（平均年龄70岁）和5，447例ICU（平均年龄58岁）入院。在入院的患者中，3，524人（18.3%）患有2型糖尿病，5，077人（26.4%）在研究期间死亡。2型糖尿病患者的死亡风险增加（校正风险比[aHR] 1.23 [95% CI 1.14，1.32]），HDU和ICU亚组的结果一致。与2型糖尿病相关的相对死亡风险随年龄增加而降低（年龄18-49岁aHR 1.50 [95% CI 1.05，2.15]，年龄50-64岁1.29 [1.10，1.51]，年龄≥65岁1.18 [1.09，1.29];年龄-2型糖尿病相互作用的P值= 0.002）。2型糖尿病可能是需要重症监护治疗的严重COVID-19患者生存的独立预后因素，在这种情况下，与2型糖尿病相关的风险增加在年轻人中最大。
To describe the relationship between type 2 diabetes and all-cause mortality among adults with coronavirus disease 2019 (COVID-19) in the critical care setting. This was a nationwide retrospective cohort study in people admitted to hospital in England with COVID-19 requiring admission to a high dependency unit (HDU) or intensive care unit (ICU) between 1 March 2020 and 27 July 2020. Cox proportional hazards models were used to estimate 30-day in-hospital all-cause mortality associated with type 2 diabetes, with adjustment for age, sex, ethnicity, obesity, and other major comorbidities (chronic respiratory disease, asthma, chronic heart disease, hypertension, immunosuppression, chronic neurological disease, chronic renal disease, and chronic liver disease). A total of 19,256 COVID-19–related HDU and ICU admissions were included in the primary analysis, including 13,809 HDU (mean age 70 years) and 5,447 ICU (mean age 58 years) admissions. Of those admitted, 3,524 (18.3%) had type 2 diabetes and 5,077 (26.4%) died during the study period. Patients with type 2 diabetes were at increased risk of death (adjusted hazard ratio [aHR] 1.23 [95% CI 1.14, 1.32]), and this result was consistent in HDU and ICU subsets. The relative mortality risk associated with type 2 diabetes decreased with higher age (age 18–49 years aHR 1.50 [95% CI 1.05, 2.15], age 50–64 years 1.29 [1.10, 1.51], and age ≥65 years 1.18 [1.09, 1.29]; P value for age–type 2 diabetes interaction = 0.002). Type 2 diabetes may be an independent prognostic factor for survival in people with severe COVID-19 requiring critical care treatment, and in this setting the risk increase associated with type 2 diabetes is greatest in younger people.
登录
查看更多内容
影响因子：
44.5
作者：
Holman, Naomi;Knighton, Peter;Valabhji, Jonathan
通讯作者：
Valabhji, Jonathan
影响因子：
39
作者：
Gupta, Shruti;Hayek, Salim S.;Leaf, David E.
通讯作者：
Leaf, David E.
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,
影响因子：
8.2
作者：
Cariou, Bertrand;Hadjadj, Samy;Gourdy, Pierre
通讯作者：
Gourdy, Pierre
影响因子：
8.8
作者：
Roncon, Loris;Zuin, Marco;Zuliani, Giovanni
通讯作者：
Zuliani, Giovanni