Can diabetes and its related hypoglycemic drug treatment be considered risk factors for health outcomes in COVID-19 patients? The results of a study in the population residing in Sicily Region (Southern Italy)
Can diabetes and its related hypoglycemic drug treatment be considered risk factors for health outcomes in COVID-19 patients? The results of a study in the population residing in Sicily Region (Southern Italy)
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DOI：
10.19191/ep20.5-6.s2.132
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发表时间：
2020-09-01
影响因子：
1.4
通讯作者：
Scondotto, Salvatore
中科院分区：
文献类型：
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作者：
Cernigliaro, Achille;Allotta, Alessandra Vincenza;Scondotto, Salvatore
目的：评估西西里岛人群中既存糖尿病状况和使用抗糖尿病药物对COVID-19疾病不同结果的影响。设计：采用回顾性观察性研究。数据来源于COVID-19疫情监测和收集西西里岛居民消费的药物信息。设置和参与者：由于数据可用性，该研究在该地区进行校准，并包括按性别和年龄组区分的所有人群。在患有糖尿病合并症导致COVID-19住院的人群中研究了COVID-19累积发病率的风险，在重症监护室接受治疗，致命性结果：在西西里，从01.03.2020到26.06.2020，确诊了172例COVID-19疾病合并糖尿病。数据显示，糖尿病患者（64.2/100，000居民）和非糖尿病患者（56.9/100，000居民）之间COVID-19的累积发病率没有任何差异。糖尿病增加了80岁以下男性和女性的住院风险（男性：OR 2.62;女性OR 4.31），重症监护治疗（男性：OR 4.41;女性：OR 7.74）和死亡（男性：OR 5.21;女性OR 5.92）。药物使用分析显示，在单组分（OR 0.44）和多组分（OR 0.43）中，胰岛素（OR 2.13）对住院的风险影响，磺脲类/格列奈类（OR 2.58）对重症监护和二甲双胍对死亡的保护作用。结论：数据的可用性使得有可能监测西西里COVID-19病例的发生并探索其一些特征。糖尿病似乎并不代表西西里SARS-CoV-2感染的危险因素，而先前的糖尿病状况似乎决定了80岁以上患者住院、重症监护治疗和致死率的更大风险。此外，还存在性别差异，仅住院和重症监护的女性风险几乎是男性的两倍。在调查的抗糖尿病药物中，有住院和重症监护的风险，同时保护死亡。这项研究是在该地区启动干预方案的一个重要工具，这些方案针对的是因这一新的大流行病的影响而面临更大健康风险的人群。
OBJECTIVES: to evaluate the effects of a pre-existing condition of diabetes and of the use of antidiabetic drugs in the Sicilian population on different outcomes of the COVID-19 disease.DESIGN: a retrospective observational study based was used. Data deriving from the COVID-19 epidemic surveillance and from the collection of information on drugs consume by Sicilian residents.SETTING AND PARTICIPANTS: due to the data availability, the study was calibrated on the Region and included all population distinguishing by gender and age groups.MAIN OUTCOME MEASURES: the risks of cumulative incidence for COVID-19 were investigated in people who had diabetes comorbidities to incur a hospitalization for COVID-19, to be treated within an intensive care unit, and lethality. The role of previous antidiabetic drug treatments with respect to each study outcome was also investigated.RESULTS: in Sicily, from 01.03.2020 to 26.06.2020, a number of 172 cases of COVID-19 disease with diabetes comorbidity were diagnosed. The data did not show any difference in the cumulative incidence for COVID-19 between diabetics (64.2/100,000 inhabitants) and non-diabetics (56.9/100,000 inhabitants) patients. Diabetes increases the risk of hospitalization in the under 80 in both men and women (men: OR 2.62; women OR 4.31), for treatment in intensive care (men: OR 4,41; women: OR 7.74), and for death (men: OR 5.21;women OR 5.92). The analysis of drug using showed risks effect of insulin (OR 2.13) on hospitalization, sulfonylureas/glinides (OR 2.58) on intensive care and protective of metformin on death both in single component (OR 0.44) and in multicomponent (OR 0.43).CONCLUSIONS: data availability made it possible to monitor the occurrence and explore some of the characteristics of the cases with COVID-19 in Sicily. Diabetes does not seem to represent a risk factor for SARS-CoV-2 infection in Sicily, while previous diabetes condition seems to determine greater risk of hospitalization, treatment in intensive care, and lethality among over 80. There are also gender differences with almost double risks in women for hospitalization and intensive care only. Among the antidiabetic drugs investigated, there was a risk for hospitalization and intensive care while protective for deaths. This study represents an important tool for the activation of intervention programmes in the area aimed at populations with greater health risk deriving from the effects of this new pandemic.