Background: Coronavirus disease 2019 (COVID-19) has been reported to be associated with a more severe course in patients with type 2 diabetes mellitus (T2DM). However, severe adverse outcomes are not recorded in all patients. In this study, we assessed disease outcomes in patients with and without T2DM hospitalized for COVID-19.
Methods: A nationwide retrospective cohort of patients with T2DM hospitalized with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. Multivariate modeling was used to assess the independent predictors of demographic and clinical characteristics with mortality, length of hospital stay, and intensive care unit (ICU) admission and/or mechanical ventilation.
Results: A total of 18 426 inpatients (median age [interquartile range, IQR]: 61  years; males: 43.3%) were investigated. Patients with T2DM (n = 9213) were compared with a group without diabetes (n = 9213) that were matched using the propensity scores for age and gender. Compared with the group without T2DM, 30-day mortality following hospitalization was higher in patients with T2DM (13.6% vs 8.7%; hazard ratio 1.75; 95% CI, 1.58-1.93; P < .001). The independent associates of mortality were older age, male gender, obesity, insulin treatment, low lymphocyte count, and pulmonary involvement on admission. Older age, low lymphocyte values, and pulmonary involvement at baseline were independently associated with longer hospital stay and/or ICU admission.
Conclusions: The current study from the Turkish national health care database showed that patients with T2DM hospitalized for COVID-19 are at increased risk of mortality, longer hospital stay, and ICU admission.
背景: 新冠肺炎(COVID-19)与2型糖尿病(T2DM)患者的病程密切相关。然而，并不是所有的患者都有严重的不良后果。在这项研究中，我们评估了有和没有因COVID-19住院的T2DM患者的疾病结局。 方法: 对2020年3月11日至5月30日在土耳其卫生部数据库中确诊为COVID-19的T2 DM患者进行全国性回顾性队列调查。多变量模型用于评估人口学和临床特征与死亡率、住院时间、重症监护病房(ICU)入院和/或机械通气的独立预测因素。 结果: 共调查18426例住院患者(中位年龄[四分位数范围，IQR]:61岁；男性:43.3%)。T2 DM患者(n=9213)与非糖尿病患者(n=9213)进行年龄和性别倾向评分相匹配的比较。与非T2 DM组相比，T2 DM患者住院30d死亡率较高(13.6%比8.7%；危险比1.75；95%CI，1.58~1.93；P<0.001)。影响死亡率的独立因素是高龄、男性、肥胖、胰岛素治疗、淋巴细胞计数低和入院时肺部受累。年龄大、淋巴细胞值低和基线时肺部受累与较长的住院和/或ICU入院时间独立相关。 结论: 来自土耳其国家卫生保健数据库的研究显示，因COVID-19而住院的T2DM患者的死亡率、住院时间和ICU入院的风险增加。.
Keywords: 2型糖尿病; COVID-19; hospital stay; intensive care unit admission; mortality; type 2 diabetes; 住院时间; 新冠肺炎; 死亡率; 重症监护病房入院.
© 2021 Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.