Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019
Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019
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DOI：
10.3389/fendo.2020.00525
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发表时间：
2020-07-10
影响因子：
5.2
通讯作者：
Zeng, Tianshu
中科院分区：
文献类型：
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作者：
Zhang, Jiaoyue;Kong, Wen;Zeng, Tianshu
背景：糖尿病与COVID-19患者预后不良相关，但很少有研究评估空腹血糖受损（IFG）是否也是COVID-19患者预后不良的危险因素。本研究旨在研究COVID-19患者入院时IFG与糖尿病、并发症风险和死亡率之间的关系。方法：在这项多中心回顾性队列研究中，我们纳入了2020年1月1日至3月17日武汉市5家医院的312例COVID-19住院患者。收集临床资料、实验室结果、并发症、治疗方案和死亡率状况。采用Cox比例风险回归模型分析入院时高血糖和糖尿病状况与主要复合终点事件（包括机械通气、入住重症监护病房或死亡）之间的关系。结果：患者中位年龄为57岁（四分位数范围38-66），172例（55%）为女性。入院时，84例（27%）患有糖尿病（36例为新诊断），62例（20%）患有IFG， 166例（53%）空腹血糖（NFG）水平正常。与NFG患者相比，IFG合并糖尿病患者发生了更多的主要复合终点事件（9[5%],11[18%],26[31%]），包括接受机械通气（5[3%],6[10%],21[25%]）和死亡（4[2%],9[15%],20[24%]）。多变量Cox回归分析显示，在调整了年龄、性别、医院和合并症等因素后，糖尿病与主要复合终点事件（风险比3.53；95%置信区间1.48 ~ 8.40）和死亡率（6.25;1.91 ~ 20.45）的风险增加相关，IFG与死亡率（4.11;1.15 ~ 14.74）的风险增加相关。结论：入院时IFG和糖尿病与COVID-19患者不良结局的高风险相关。
Background:Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods:In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results:The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion:IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.