Diabetes patients with comorbidities had unfavorable outcomes following COVID-19:A retrospective study  

作　　者：Shun-Kui Luo Wei-Hua Hu Zhan-Jin Lu Chang Li Ya-Meng Fan Qi-Jian Chen Zai-Shu Chen Jian-Fang Ye Shi-Yan Chen Jun-Lu Tong Ling-Ling Wang Jin Mei Hong-Yun Lu 

机构地区：[1]Department of Endocrinology and Metabolism,the Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,Guangdong Province,China [2]Department of Respiratory Medicine,The First Hospital of Jingzhou,Clinical Medical College,Yangtze University,Jingzhou 434000,Hubei Province,China [3]Department of Cardiology,Hubei No.3 People’s Hospital of Jianghan University,Wuhan 430033,Hubei Province,China [4]School of Health Sciences,Wuhan University,Wuhan 430071,Hubei Province,China [5]Department of Emergency Medicine,The Fifth Hospital in Wuhan,Wuhan 430050,Hubei Province,China [6]People's Hospital of Jiayu County,Jiayu 437200,Hubei Province,China [7]Department of Gerontology,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai 519000,Guangdong Province,China [8]Department,Wenzhou Medical University,Wenzhou 325035,Zhejiang Province,China [9]Central Laboratory,Ningbo First Hospital of Zhejiang University,Ningbo 315010,Zhejiang Province,China [10]Department of Endocrinology and Metabolism,Zhuhai Hospital Affiliated with Jinan University,Zhuhai 519000,Guangdong Province,China

出　　处：《World Journal of Diabetes》2021年第10期1789-1808,共20页世界糖尿病杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China(General Program);No.81670815;Guangdong Basic and Applied Basic Research Foundation,No.2020A1515010124,No.2021A1515010695;Special Fund for Innovation Strategy of Science and Technology plan of Guangdong Province,No.2019A030317011。

摘　　要：BACKGROUND Previous studies have shown that diabetes mellitus is a common comorbidity of coronavirus disease 2019(COVID-19),but the effects of diabetes or anti-diabetic medication on the mortality of COVID-19 have not been well described.AIM To investigate the outcome of different statuses(with or without comorbidity)and anti-diabetic medication use before admission of diabetic after COVID-19.METHODS In this multicenter and retrospective study,we enrolled 1422 consecutive hospitalized patients from January 21,2020,to March 25,2020,at six hospitals in Hubei Province,China.The primary endpoint was in-hospital mortality.Epidemiological material,demographic information,clinical data,laboratory parameters,radiographic characteristics,treatment and outcome were extracted from electronic medical records using a standardized data collection form.Most of the laboratory data except fasting plasma glucose(FPG)were obtained in first hospitalization,and FPG was collected in the next day morning.Major clinical symptoms,vital signs at admission and comorbidities were collected.The treatment data included not only COVID-19 but also diabetes mellitus.The duration from the onset of symptoms to admission,illness severity,intensive care unit(ICU)admission,and length of hospital stay were also recorded.All data were checked by a team of sophisticated physicians.RESULTS Patients with diabetes were 10 years older than non-diabetic patients[(39-64)vs(56-70),P<0.001]and had a higher prevalence of comorbidities such as hypertension(55.5%vs 21.4%,P<0.001),coronary heart disease(CHD)(9.9%vs 3.5%,P<0.001),cerebrovascular disease(CVD)(3%vs 2.2%,P<0.001),and chronic kidney disease(CKD)(4.7%vs 1.5%,P=0.007).Mortality(13.6%vs 7.2%,P=0.003)was more prevalent among the diabetes group.Further analysis revealed that patients with diabetes who took acarbose had a lower mortality rate(2.2%vs 26.1,P<0.01).Multivariable Cox regression showed that male sex[hazard ratio(HR)2.59(1.68-3.99),P<0.001],hypertension[HR 1.75(1.18-2.60),P=0.006),CKD[HR 4.55(2.52-

关 键 词：DIABETES Coronavirus disease 2019 MORTALITY Risk factors ACARBOSE 

分 类 号：R587.1[医药卫生—内分泌] R563.1[医药卫生—内科学]