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感染新型冠状病毒的2型糖尿病患者的临床特征和结果——一项回顾性研究
Yingyu Chen, Jiankun Chen, Xiao Gong, Xianglu Rong, Dewei Ye, Yinghua Jin, Zhongde Zhang, Jiqiang Li, Jiao Guo
工程（英文） ›› 2020, Vol. 6 ›› Issue (10) : 1170-1177.
PDF(330 KB)
PDF(330 KB)
感染新型冠状病毒的2型糖尿病患者的临床特征和结果——一项回顾性研究
Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with SARS-CoV-2: A Retrospective Study
据报道，糖尿病及其相关的代谢性疾病是新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）患者的主要合并症。这项临床研究旨在调查有或没有合并糖尿病的COVID-19患者的临床特征、影像学和实验室检查、并发症、治疗方法以及临床结局。这项回顾性研究纳入2020年1月12日至3月25日208例经实验室确认的COVID-19的住院患者（≥45岁）。分析病历信息包括临床特征、影像学和实验室检查、并发症、治疗和临床结果。其中，96名（46.2％）患者患有2型糖尿病。在COVID-19合并2型糖尿病患者中，高血压（58.3％ vs. 31.2％）、冠心病（17.1％ vs. 8.0％）和慢性肾脏病（6.2％ vs. 0％）的共存率明显高于没有2型糖尿病的COVID-19患者。COVID-19合并2型糖尿病患者的CT胸部扫描异常频率和程度显著增加，包括毛玻璃样混浊（85.6％ vs. 64.9％, P < 0.001）和双侧斑片状阴影（76.7％ vs. 37.8％, P < 0.001）。此外，患有糖尿病的COVID-19患者的血糖水平[7.23 mmol·L‒1 (IQR: 5.80~9.29) vs. 5.46 mmol·L‒1 (IQR: 5.00~6.46)]、血液中低密度脂蛋白胆固醇（low-density lipoprotein cholesterol, LDL-C）[2.21 mmol·L‒1 (IQR: 1.67~2.76) vs. 1.75 mmol·L‒1 (IQR: 1.27~2.01)]和收缩压[130 mmHg (IQR: 120~142) vs. 122 mmHg (IQR: 110~137), P < 0.001]显著高于没有糖尿病的患者（P < 0.001）。2型糖尿病和其他代谢性疾病共存于COVID-19患者中，这可能会增加发病率并加重COVID-19的病情。血糖和脂质代谢的最佳管理是确保更好的临床结果的关键。对于患有糖尿病及其他基础和慢性代谢性疾病的COVID-19患者，应提高临床警惕性。
Diabetes and its related metabolic disorders have been reported as the leading comorbidities in patients with coronavirus disease 2019 (COVID-19). This clinical study aims to investigate the clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes in COVID-19 patients with or without diabetes. This retrospective study included 208 hospitalized patients (≥ 45 years old) with laboratory-confirmed COVID-19 during the period between 12 January and 25 March 2020. Information from the medical record, including clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes, were extracted for the analysis. 96 (46.2%) patients had comorbidity with type 2 diabetes. In COVID-19 patients with type 2 diabetes, the coexistence of hypertension (58.3% vs 31.2%), coronary heart disease (17.1% vs 8.0%), and chronic kidney diseases (6.2% vs 0%) was significantly higher than in COVID-19 patients without type 2 diabetes. The frequency and degree of abnormalities in computed tomography (CT) chest scans in COVID-19 patients with type 2 diabetes were markedly increased, including ground-glass opacity (85.6% vs 64.9%, P < 0.001) and bilateral patchy shadowing (76.7% vs 37.8%, P < 0.001). In addition, the levels of blood glucose (7.23 mmol·L‒1 (interquartile range (IQR): 5.80–9.29) vs 5.46 mmol·L‒1 (IQR: 5.00–6.46)), blood low-density lipoprotein cholesterol (LDL-C) (2.21 mmol·L‒1 (IQR: 1.67–2.76) vs 1.75 mmol·L‒1 (IQR: 1.27–2.01)), and systolic pressure (130 mmHg (IQR: 120–142) vs 122 mmHg (IQR: 110–137)) (1 mmHg = 133.3 Pa) in COVID-19 patients with diabetes were significantly higher than in patients without diabetes (P < 0.001). The coexistence of type 2 diabetes and other metabolic disorders is common in patients with COVID-19, which may potentiate the morbidity and aggravate COVID-19 progression. Optimal management of the metabolic hemostasis of glucose and lipids is the key to ensuring better clinical outcomes. Increased clinical vigilance is warranted for COVID-19 patients with diabetes and other metabolic diseases that are fundamental and chronic conditions.
新冠病毒肺炎 / 冠状病毒 / 糖尿病 / 临床特征 / 合并症
COVID-19 / Coronavirus disease / Diabetes / Clinical characteristics / Comorbidities
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