Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study.
Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study.
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DOI：
10.3803/enm.2020.719
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Moon JS
中科院分区：
文献类型：
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作者：
Chang MC;Hwang JM;Jeon JH;Kwak SG;Park D;Moon JS
冠状病毒病2019年(新冠肺炎)已成为一种全球大流行，这促使人们达成共识，有必要寻找这一关键疾病的风险因素。影响该病死亡率的风险因素仍然难以捉摸。众所周知，糖尿病和高血糖会对宿主的抗病毒免疫产生负面影响。我们评估了新冠肺炎重症患者的糖尿病病史、空腹血糖水平和死亡率之间的关系。这是一项回顾性队列研究，评估了来自韩国大邱两家三级医院的106名成年住院患者(年龄≥为18岁)。参与者被转移到三级医院，因为他们的身体状况需要立即进行重症监护。对存活和未存活的新冠肺炎患者的人口统计学和实验室数据进行了比较。与存活组相比，死亡组的年龄、糖尿病、慢性肺部疾病和空腹血糖的比例显著升高。在生存分析的Cox比例风险回归模型中，空腹血糖水平和年龄被认为是死亡率的显著预测因素(P<；0.05)。预测高死亡率的阈值分别为68岁和空腹血糖168 mg/dL。在非糖尿病患者中，高空腹血糖仍然是死亡率的重要预测因子(P<；0.04)。无论已知的糖尿病病史如何，高空腹血糖水平都能显著预测新冠肺炎患者的死亡率。这些结果提示对空腹血糖水平较高的新冠肺炎患者应加强监测。
Coronavirus disease 2019 (COVID-19) has become a global pandemic, which prompts a consensus for the necessity to seek risk factors for this critical disease. Risk factors affecting mortality of the disease remain elusive. Diabetes and hyperglycemia are known to negatively affect a host’s antiviral immunity. We evaluated the relationship between a history of diabetes, fasting plasma glucose (FPG) levels and mortality among severely ill patients with COVID-19. This was a retrospective cohort study that assessed 106 adult inpatients (aged ≥18 years) from two tertiary hospitals in Daegu, South Korea. The participants were transferred to tertiary hospitals because their medical condition required immediate intensive care. The demographic and laboratory data were compared between COVID-19 patients who survived and those who did not. Compared with the survivor group, age, and the proportions of diabetes, chronic lung disease and FPG were significantly higher in the deceased group. In the Cox proportional hazards regression model for survival analysis, FPG level and age were identified as significant predictors of mortality (P<0.05). The threshold values for predicting high mortality were age >68 years and FPG of 168 mg/dL, respectively. Among those without diabetes, high FPG remained a significant predictor of mortality (P<0.04). High FPG levels significantly predicted mortality in COVID-19, regardless of a known history of diabetes. These results suggest intensive monitoring should be provided to COVID-19 patients who have a high FPG level.