Clinical Features of COVID-19 Patients with Diabetes and Secondary Hyperglycemia.
Clinical Features of COVID-19 Patients with Diabetes and Secondary Hyperglycemia.
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患有糖尿病和继发性高血糖的 COVID-19 患者的临床特征
DOI：
10.1155/2020/3918723
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发表时间：
2020
影响因子：
4.3
通讯作者：
Hu Q
中科院分区：
文献类型：
--
作者：
Zhou W;Ye S;Wang W;Li S;Hu Q
糖尿病患者发生各种感染的风险更高。因此，这些糖尿病患者感染新冠病毒（COVID - 19）的风险可能增加，且预后较差。截至目前，关于糖尿病在新冠发病机制中的关键作用知之甚少。本研究旨在探讨合并糖尿病及继发性高血糖的COVID - 19患者的临床特征，并探究其潜在机制。80例确诊的COVID - 19患者被分为血糖正常组、继发性高血糖组和糖尿病组。COVID - 19的严重程度依据中国国家卫生健康委员会发布的新型冠状病毒肺炎诊疗指南来界定。根据疾病严重程度，轻型和普通型患者被登记为轻症病例（症状轻微且CT检查结果为阴性的患者），而重型和危重型患者被纳入重症病例（CT检查结果为阳性且有不同程度临床表现的患者）。糖尿病组患者年龄大于血糖正常组，且大多数为男性。糖尿病组中重症病例比例为57.14%，显著高于其他两组，且32%被诊断为重症的COVID - 19患者患有糖尿病。糖尿病组的CD4 +细胞计数低于其他两组，而乳酸脱氢酶（LDH）和超敏C反应蛋白（hs - CRP）水平更高。与血糖正常组相比，继发性高血糖组和糖尿病组的CD3 +细胞计数及CD4 + / CD8 +比值降低，而白细胞介素 - 6（IL - 6）水平升高，其中糖尿病组的差异尤为显著。Spearman相关性分析显示，糖尿病的存在与年龄、hs - CRP、LDH、IL - 6、CD8 +细胞及COVID - 19严重程度呈正相关，与CD3 +细胞计数、CD4 +细胞计数及CD4 + / CD8 +比值呈负相关。与其他两组相比，糖尿病组在CT影像学上表现出更多样化和多灶性特征。由于持续炎症和免疫反应受损，糖尿病是影响COVID - 19病情进展和预后的一个危险因素。
People with diabetes have higher risks of various infections. Therefore, these diabetic patients might be at increased risk of COVID-19 and have a poorer prognosis. Up until now, little is known about critical role in the pathogenesis. This study aims to investigate the clinical characteristics of COVID-19 patients with diabetes and secondary hyperglycemia, as well as to explore the purported mechanisms. 80 confirmed COVID-19 subjects were classified into the euglycemia group, secondary hyperglycemia group, and diabetes group. Severity of COVID-19 was defined based on the diagnostic and treatment guideline for SARS-CoV-2 issued by Chinese National Health Committee. According to the severity of the disease, patients of the mild type and common type were registered as mild cases (patients with minimal symptoms and negative CT findings), while patients of the severe type and critical type were enrolled as severe cases (patients with positive CT findings and different extent of clinical manifestations). Patients in the diabetes group were older than those in the euglycemia group, and most of them were male. In the diabetes group, the proportion of severe cases was 57.14%, which was significantly higher than those in the other two groups, and 32% of the COVID-19 patients diagnosed as severe cases were with diabetes. The CD4+ cell counts in the diabetes group were lower than those in the other two groups, while the levels of LDH and hs-CRP were higher. Compared with the euglycemia group, the CD3+ cell counts and the CD4+/CD8+ ratio were decreased, whereas the levels of IL-6 were increased in the secondary hyperglycemia group and diabetes group, with the diversities in the diabetes group being especially more significant. The Spearman correlation analysis revealed that the presence of diabetes was positively correlated with age, hs-CRP, LDH, IL-6, CD8+ cells, and severity of COVID-19 and negatively correlated with CD3+ cell counts, CD4+ cell counts, and CD4+/CD8+ ratio. Compared with the other two groups, the diabetes group exhibited more diverse and multifocal features in CT imagings. Diabetes is a risk factor for influence of the progression and prognosis of COVID-19 due to ongoing inflammation and impaired immune response.
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影响因子：
16.2
作者：
Allard R;Leclerc P;Tremblay C;Tannenbaum TN
通讯作者：
Tannenbaum TN
影响因子：
8.8
作者：
Liu, Fang;Li, Lin;Zhou, Xiang
通讯作者：
Zhou, Xiang
SARS 冠状病毒与其受体的结合会损害胰岛并导致急性糖尿病
影响因子：
3.8
作者：
Yang JK;Lin SS;Ji XJ;Guo LM
通讯作者：
Guo LM
DOI：
10.1001/jama.289.21.joc30885
发表时间：
2003-06-04
影响因子：
120.7
作者：
Booth, CM;Matukas, LM;Detsky, AS
通讯作者：
Detsky, AS
影响因子：
--
作者：
Toniolo, Antonio;Cassani, Gianluca;Ferrannini, Ele
通讯作者：
Ferrannini, Ele