Hyperglycemia and Correlated High Levels of Inflammation Have a Positive Relationship with the Severity of Coronavirus Disease 2019.
Hyperglycemia and Correlated High Levels of Inflammation Have a Positive Relationship with the Severity of Coronavirus Disease 2019.
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高血糖和相关的高水平炎症与 2019 年冠状病毒病的严重程度呈正相关
DOI：
10.1155/2021/8812304
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发表时间：
2021
影响因子：
4.6
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Zhang W;Li C;Xu Y;He B;Hu M;Cao G;Li L;Wu S;Wang X;Zhang C;Zhao J;Xie J;Xu Z;Li Q;Wang G
目标 2019 年冠状病毒病 (COVID-19) 是一个相当大的全球公共卫生威胁。本研究旨在调查血糖 (BG) 水平或合并糖尿病是否与 COVID-19 患者的炎症状态和疾病严重程度相关。方法 在这项回顾性队列研究中，比较了患有或不患有糖尿病的 COVID-19 患者的临床和生化特征。分析了 COVID-19 的严重程度、炎症状态与糖尿病或高血糖之间的关系。所有患者的COVID-19严重程度均根据中国国家卫生健康委员会发布的诊断和治疗指南（第七版）确定。结果本研究共纳入461例患者，其中71.58%的糖尿病患者和13.03%的非糖尿病患者存在高血糖。与非糖尿病患者（n = 366）相比，糖尿病患者（n = 95）的白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比率（NLR）和红细胞沉降率（ESR）较高。根据年龄、性别、体重指数 (BMI)、已知高血压和冠心病进行调整后，COVID-19 的严重程度与已知糖尿病之间没有关联。白细胞计数、NLR 和 C 反应蛋白 (CRP) 水平随着 BG 水平的增加而增加。高血糖是危重（OR 4.00，95% CI 1.72-9.30）或严重（OR 3.55，95% CI 1.47-8.58）COVID-19以及炎症水平升高（高白细胞计数（OR 4.26，95% CI 1.65-10.97）、NLR（OR 2.76， 95% CI 1.24-6.10），以及 调整年龄、性别、BMI、疾病严重程度和已知糖尿病后的 CRP 水平（OR 2.49，95% CI 1.19-5.23））。结论 高血糖与较高的炎症水平和较严重的病情呈正相关，是 COVID-19 严重程度增加的危险因素。住院后对血浆葡萄糖水平的初步测量可能有助于识别易于出现更严重临床病程的患者子集。
Objective Coronavirus disease 2019 (COVID-19) is a considerable global public health threat. This study sought to investigate whether blood glucose (BG) levels or comorbid diabetes are associated with inflammatory status and disease severity in patients with COVID-19. Methods In this retrospective cohort study, the clinical and biochemical characteristics of COVID-19 patients with or without diabetes were compared. The relationship among severity of COVID-19, inflammatory status, and diabetes or hyperglycemia was analyzed. The severity of COVID-19 in all patients was determined according to the diagnostic and treatment guidelines issued by the Chinese National Health Committee (7th edition). Results Four hundred and sixty-one patients were enrolled in our study, and 71.58% of patients with diabetes and 13.03% of patients without diabetes had hyperglycemia. Compared with patients without diabetes (n = 366), patients with diabetes (n = 95) had a higher leucocyte count, neutrophil count, neutrophil to lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR). There was no association between severity of COVID-19 and known diabetes adjusted for age, sex, body mass index (BMI), known hypertension, and coronary heart disease. The leucocyte count, NLR, and C-reactive protein (CRP) level increased with increasing BG level. Hyperglycemia was an independent predictor of critical (OR 4.00, 95% CI 1.72-9.30) or severe (OR 3.55, 95% CI 1.47-8.58) COVID-19, and of increased inflammatory levels (high leucocyte count (OR 4.26, 95% CI 1.65-10.97), NLR (OR 2.76, 95% CI 1.24-6.10), and CRP level (OR 2.49, 95% CI 1.19-5.23)), after adjustment for age, sex, BMI, severity of illness, and known diabetes. Conclusion Hyperglycemia was positively correlated with higher inflammation levels and more severe illness, and it is a risk factor for the increased severity of COVID-19. The initial measurement of plasma glucose levels after hospitalization may help identify a subset of patients who are predisposed to a worse clinical course.
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