Association Between Diabetes Severity and Risks of COVID-19 Infection and Outcomes.
Association Between Diabetes Severity and Risks of COVID-19 Infection and Outcomes.
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DOI：
10.1007/s11606-023-08076-9
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发表时间：
2023-05
影响因子：
5.7
通讯作者：
Dublin, Sascha
中科院分区：
文献类型：
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作者：
Floyd, James S.;Walker, Rod L.;Kuntz, Jennifer L.;Shortreed, Susan M.;Fortmann, Stephen P.;Bayliss, Elizabeth A.;Harrington, Laura B.;Fuller, Sharon;Albertson-Junkans, Ladia H.;Powers, John D.;Lee, Mi H.;Temposky, Lisa A.;Dublin, Sascha
关于糖尿病是否会增加 COVID-19 感染的风险以及糖尿病严重程度的衡量标准是否与 COVID-19 结果相关，人们知之甚少。调查糖尿病严重程度测量作为 COVID-19 感染和 COVID-19 结果的潜在危险因素。在科罗拉多州、俄勒冈州和华盛顿州的综合医疗保健系统中，我们于 2020 年 2 月 29 日确定了一组成年人（n = 1,086,918），并进行了截至 2021 年 2 月 28 日的随访。电子健康数据和死亡证明用于识别糖尿病严重程度、协变量和结果的标记。结果是 COVID-19 感染（核酸抗原检测呈阳性、COVID-19 住院治疗或 COVID-19 死亡）和重症 COVID-19（有创机械通气或 COVID-19 死亡）。将患有糖尿病的个体（n = 142,340）和糖尿病严重程度测量类别与无糖尿病的参考组（n = 944,578）进行比较，调整人口变量、邻里剥夺指数、体重指数和合并症。在 30,935 名 COVID-19 感染患者中，有 996 名符合重症 COVID-19 的标准。 1 型糖尿病（比值比 [OR] 1.41，95% CI 1.27–1.57）和 2 型糖尿病（OR 1.27，95% CI 1.23–1.31）与 COVID-19 感染风险增加相关。与非胰岛素药物治疗（OR 1.26，95% 1.20-1.33）或不治疗（OR 1.24；1.18-1.29）相比，胰岛素治疗与更高的 COVID-19 感染风险（OR 1.43，95% CI 1.34-1.52）相关。血糖控制与 COVID-19 感染风险之间的关系呈剂量依赖性：从血红蛋白 A1c (HbA1c) < 7% 的 OR 1.21 (95% CI 1.15–1.26) 到 HbA1c ≥ 9% 的 OR 1.62 (95% CI 1.51–1.75)。重症COVID-19的危险因素为1型糖尿病（OR 2.87；95% CI 1.99–4.15）、2型糖尿病（OR 1.80；95% CI 1.55–2.09）、胰岛素治疗（OR 2.65；95% CI 2.13–3.28）和HbA1c ≥ 9%（OR 2.61；95% CI 1.55–2.09）。 95% CI 1.94–3.52）。糖尿病和糖尿病严重程度与 COVID-19 感染风险增加和 COVID-19 结果恶化相关。 在线版本包含可在 10.1007/s11606-023-08076-9 获取的补充材料。
Little is known about whether diabetes increases the risk of COVID-19 infection and whether measures of diabetes severity are related to COVID-19 outcomes. Investigate diabetes severity measures as potential risk factors for COVID-19 infection and COVID-19 outcomes. In integrated healthcare systems in Colorado, Oregon, and Washington, we identified a cohort of adults on February 29, 2020 (n = 1,086,918) and conducted follow-up through February 28, 2021. Electronic health data and death certificates were used to identify markers of diabetes severity, covariates, and outcomes. Outcomes were COVID-19 infection (positive nucleic acid antigen test, COVID-19 hospitalization, or COVID-19 death) and severe COVID-19 (invasive mechanical ventilation or COVID-19 death). Individuals with diabetes (n = 142,340) and categories of diabetes severity measures were compared with a referent group with no diabetes (n = 944,578), adjusting for demographic variables, neighborhood deprivation index, body mass index, and comorbidities. Of 30,935 patients with COVID-19 infection, 996 met the criteria for severe COVID-19. Type 1 (odds ratio [OR] 1.41, 95% CI 1.27–1.57) and type 2 diabetes (OR 1.27, 95% CI 1.23–1.31) were associated with increased risk of COVID-19 infection. Insulin treatment was associated with greater COVID-19 infection risk (OR 1.43, 95% CI 1.34–1.52) than treatment with non-insulin drugs (OR 1.26, 95% 1.20–1.33) or no treatment (OR 1.24; 1.18–1.29). The relationship between glycemic control and COVID-19 infection risk was dose-dependent: from an OR of 1.21 (95% CI 1.15–1.26) for hemoglobin A1c (HbA1c) < 7% to an OR of 1.62 (95% CI 1.51–1.75) for HbA1c ≥ 9%. Risk factors for severe COVID-19 were type 1 diabetes (OR 2.87; 95% CI 1.99–4.15), type 2 diabetes (OR 1.80; 95% CI 1.55–2.09), insulin treatment (OR 2.65; 95% CI 2.13–3.28), and HbA1c ≥ 9% (OR 2.61; 95% CI 1.94–3.52). Diabetes and greater diabetes severity were associated with increased risks of COVID-19 infection and worse COVID-19 outcomes. The online version contains supplementary material available at 10.1007/s11606-023-08076-9.
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影响因子：
16.2
作者：
Hartmann-Boyce J;Rees K;Perring JC;Kerneis SA;Morris EM;Goyder C;Otunla AA;James OA;Syam NR;Seidu S;Khunti K
通讯作者：
Khunti K
影响因子：
3.9
作者：
Shortreed SM;Gray R;Akosile MA;Walker RL;Fuller S;Temposky L;Fortmann SP;Albertson-Junkans L;Floyd JS;Bayliss EA;Harrington LB;Lee MH;Dublin S
通讯作者：
Dublin S
DOI：
10.1038/s41366-021-01054-3
发表时间：
2022-05
期刊：
International journal of obesity (2005)
影响因子：
--
作者：
Gao M;Wang Q;Piernas C;Astbury NM;Jebb SA;Holmes MV;Aveyard P
通讯作者：
Aveyard P
影响因子：
16.2
作者：
Selvin, Elizabeth;Juraschek, Stephen P.
通讯作者：
Juraschek, Stephen P.
影响因子：
6.3
作者：
Roux, AVD;Borrell, LN;Schultz, R
通讯作者：
Schultz, R