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Hyperglycemia is a strong predictor of poor prognosis in COVID-19.

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单位: [1]Department of Endocrinology, The third Xiangya Hospital, Central South University, 410007 Changsha, Hunan, China [2]Department of Orthopedics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China. [3]Department of infectious diseases, The second Xiangya Hospital, Central South University, 410007 Changsha, Hunan, China
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关键词: COVID-19 SARS-CoV-2 Hyperglycemia Diabetes

摘要:
The objective of this study is to explore the association between documented diabetes, fasting plasma glucose (FPG), and the clinical outcomes of Coronavirus disease 2019 (COVID-19). This retrospective study included 255 patients with COVID-19. Of these, 214 were admitted to isolation wards and 41were admitted to intensive care units (ICUs). Demographic, clinical, treatment, and laboratory data were collected and compared between ICU and non-ICU patients. Multivariable logistic regression models were used to explore the risk factors associated with poor clinical outcomes (ICU admission or death). There were significant changes in several clinical parameters in ICU patients (leukopenia, lymphopenia, elevated D-dimer, as well as higher levels of FPG, cardiac troponin, serum ferritin, IL-6, and high-sensitivity C-reactive protein)compared with non-ICU patients. The prevalence of known diabetes was substantially higher in ICU than non-ICU patients (31.7% vs. 17.8%, P = 0.0408). Multivariable regression analysis showed that a history of diabetes [odds ratio (OR), 0.099; 95% confidence interval (CI), 0.016-0.627; P = 0.014], high FPG at admission (OR, 1.587; 95% CI, 1.299-1.939, P < 0.001), high IL-6 (OR, 1.01; 95% CI, 1.002-1.018, P = 0.013), and D-dimer higher than 1 mg/L at admission (OR, 4.341; 95% CI, 1.139-16.547, P = 0.032) were independent predictors of poor outcomes. Cox proportional hazards analysis showed that compared with FPG < 7 mmol/L, FPG levels of 7.0-11.1 mmol/L and ≥ 11.1 mmol/L were associated with an increased hazard ratio (HR) for poor outcome (HR, 5.538 [95% CI, 2.269-13.51] and HR, 11.55 [95% CI, 4.45-29.99], respectively). Hyperglycemia and a history of diabetes on admission predicted poor clinical outcomes in COVID-19. Copyright © 2020 Elsevier B.V. All rights reserved.

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基金编号: 81670730 81100583 2016JJ4103 2018JJ3796

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 内分泌学与代谢
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 内分泌学与代谢
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出版当年[2018]版:
Q2 ENDOCRINOLOGY & METABOLISM
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Q1 ENDOCRINOLOGY & METABOLISM

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第一作者单位: [1]Department of Endocrinology, The third Xiangya Hospital, Central South University, 410007 Changsha, Hunan, China
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通讯机构: [1]Department of Endocrinology, The third Xiangya Hospital, Central South University, 410007 Changsha, Hunan, China [*1]Department of Endorcrinology The third Xiangya Hospital Central South University Tongzipo Road, Changsha, Hunan Province, the People's Republic of China
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