Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes
Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes
复制标题
DOI：
10.1016/j.cmet.2020.04.021
复制
发表时间：
2020-06-02
期刊：
影响因子：
29
通讯作者：
Li, Hongliang
中科院分区：
文献类型：
--
作者：
Zhu, Lihua;She, Zhi-Gang;Li, Hongliang
2型糖尿病（T2D）是COVID-19的主要合并症。然而，血糖（BG）控制对COVID-19合并T2D患者所需医疗干预程度和死亡率的影响仍不确定。因此，我们对中国湖北省7337例COVID-19病例进行了回顾性、多中心研究，其中952例已存在T2D。我们发现，与非糖尿病患者相比，T2D患者需要更多的医疗干预，且死亡率（7.8% vs 2.7%；校正风险比[HR]， 1.49）和多器官损伤明显更高。此外，我们发现，在住院期间，与血糖控制不佳（血糖变异性上限超过10.0 mmol/L）的患者相比，血糖控制良好（血糖变异性在3.9至10.0 mmol/L之间）的患者死亡率显著降低（调整后HR， 0.14）。这些发现为COVID-19合并t2dm患者血糖控制改善与预后改善之间的关系提供了临床证据。
Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D.