Clinical characteristics and outcomes of coronavirus disease 2019 infections among diabetics: A retrospective and multicenter study in China
合并糖尿病的新型冠状病毒肺炎患者临床特征及预后:中国一项多中心回顾性研究
Huahua Yi, Fangying Lu, and Xiaoyan Jin contributed equally to this work.
Funding information: Clinical COVID-19 Focused Research Program (Translational Medicine Funding of Shanghai Jiao Tong University); National Key R&D Program of China, Grant/Award Numbers: 2017YFC1309700, 2017YFC1309701; Shanghai Key Discipline for Respiratory Diseases, Grant/Award Number: 2017ZZ02014; Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project, Grant/Award Number: SHDC12018102
Abstract
enBackground
Coronavirus disease 2019 (COVID-19) emerged in December 2019 and has spread globally. Diabetics are at increased risk of infections caused by a variety of pathogens including viruses. The present research aims to describe clinical characteristics and outcomes of COVID-19 patients with diabetes.
Methods
A retrospective multicenter study of COVID-19 patients with diabetes was conducted in four hospitals in Wuhan, Shanghai, and Anhui Province. Reverse transcription polymerase chain reaction or next-generation sequencing was carried out to confirm the existence of severe acute respiratory syndrome coronavirus 2 from respiratory specimens.
Results
A total of 54 diabetics (10.36%) were recruited from among 521 COVID-19 patients, with a median age of 63 (interquartile range, 52-70) years. Among them, 51 had been previously diagnosed with diabetes and 3 had been newly diagnosed based on glycosylated hemoglobin over 6.5%. For COVID-19, 47 of the 54 patients had an exposure history. Fever (47/54, 87.04%), dry cough (36/54, 66.67%), and expectoration (21/53, 39.62%) were among the top three symptoms. Lung infiltration was bilateral (46/52, 88.46%) and multilobe (47/52, 90.38%), and ground-glass opacity (36/37, 97.30%) was the most common pattern in radiological images. Moreover, COVID-19 patients with diabetes were prone to be classified as severe or critical cases (46.30%, 25/54) and had complications such as acute lung injury, acute respiratory distress syndrome, and acute kidney injury. The proportions of intensive care unit (ICU) admissions and deaths among the COVID-19 diabetics were 14.81% (8/54) and 12.96% (7/54), respectively.
Conclusions
With older age, diabetics diagnosed as having COVID-19 were prone to develop into severe cases and exhibited a high rate of ICU admission and mortality.
摘要
zh背景
2019年12月新型冠状病毒肺炎出现并迅速在全球爆发。糖尿病患者更易于感染包括病毒在内的各种病原体。本研究旨在描述合并糖尿病的新冠肺炎患者的临床特征及预后。
方法
在武汉市金银潭医院、上海瑞金医院、上海同仁医院及安徽省铜陵医院共4家单位开展多中心回顾性临床研究。采用RT-PCR 或NGS检测呼吸道标本中SARS-Covid-2病毒。
结果
521位新冠肺炎患者中54位患有糖尿病, 中位年龄63岁(四分位间距52-70), 其中51位患者既往已诊断糖尿病, 3位因糖化血红蛋白超过6.5%新诊断为糖尿病。47位患者有新冠病毒暴露史。发热(47/54,87.04%)、干咳(36/54, 66.67%)、咳痰(21/53, 39.62%) 为主要常见症状。双肺(46/52, 88.46%)、多肺叶浸润(47/52, 90.38%)、磨玻璃影(36/37, 97.30%)为常见影像学改变。合并糖尿病的新冠患者更多发展为重症或危重症型, 也往往合并急性肺损伤、急性呼吸窘迫综合征及急性肾损伤等并发症。这类人群中14.81%(8/54)需入住重症监护病房(ICU)治疗, 12.96%(7/54)最终死亡。
结论
年龄较大的合并糖尿病的新冠肺炎患者易于发展为重症类型, 有较高的ICU入住及死亡率。
