Purpose: To analyze the impact of hyperglycemia on the clinical outcome of COVID-19 in patients with newly diagnosed diabetes (NDD). Patients and Methods: We performed a retrospective study of 3114 cases of COVID-19 without pre-existing diabetes, 351 of which had NDD, in Hubei Province, China. The Cox regression model was used to calculate the risk of adverse clinical outcomes comparing the NDD vs non-NDD group before and after propensity score-matched (PSM) analysis. Patients with NDD were further divided into a sustained hyperglycemia group, a fluctuating group, and a remitted group based on their blood glucose levels during hospitalization as well as into hypoglycemic agent users and nonusers. Results: Compared to the non-NDD individuals, individuals with NDD had a significantly increased risk of all-cause mortality (adjusted HR after PSM, 2.65; 95% CI, 1.49-4.72; P = 0.001) and secondary outcomes involving organ damage during the 28-day follow-up period. Subgroup analyses indicated that among individuals with NDD, the individuals with remitted hyperglycemia had the lowest 28-day mortality, whereas those with sustained hyperglycemia had the highest (IRR 24.27; 95% CI, 3.21-183.36; P < 0.001). Moreover, individuals treated with hypoglycemic agents had significantly lower all-cause mortality than those not treated with hypoglycemic agents (IRR 0.08; 95% CI, 0.01-0.56; P < 0.001). Conclusion: Our study reinforces the clinical message that NDD is strongly associated with poor outcomes in COVID-19 patients. Furthermore, resolved hyperglycemia in the later phase of the disease and the use of hypoglycemic agents were associated with improved prognosis in patients with NDD.
基金:
National Key R&D Program of China (grant number 2016YFF0101504,
2020YFC2004702), the Special Foundation for
Emergency Research on Prevention and Control of
COVID-19 of Guangdong Province (grant number
2020B1111330003), the National Science Foundation of
China (grant number 81630011, 81970364, 81970070,
81970011, 81770053, 81870171), the Hubei Science and
Technology Support Project (grant number 2019BFC582,
2018BEC473), and Medical flight plan of Wuhan
University (grant number TFJH2018006).
第一作者机构:[1]Huanggang Cent Hosp, Dept Endocrinol, Huanggang, Peoples R China[2]Huanggang Inst Translat Med, Huanggang, Peoples R China[3]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China[4]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[1]Huanggang Cent Hosp, Dept Endocrinol, Huanggang, Peoples R China[2]Huanggang Inst Translat Med, Huanggang, Peoples R China[3]Wuhan Univ, Dept Cardiol, Renmin Hosp, Wuhan, Peoples R China[4]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China[8]Wuhan Univ, Med Sci Res Ctr, Zhongnan Hosp, Wuhan, Peoples R China
推荐引用方式(GB/T 7714):
Lin Lijin,Chen Ze,Ding Ting,et al.Newly-Diagnosed Diabetes and Sustained Hyperglycemia are Associated with Poorer Outcomes in COVID-19 Inpatients Without Pre-Existing Diabetes[J].DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY.2021,14:4469-4482.doi:10.2147/DMSO.S332819.
APA:
Lin, Lijin,Chen, Ze,Ding, Ting,Liu, Hui,Zhou, Feng...&Li, Hongliang.(2021).Newly-Diagnosed Diabetes and Sustained Hyperglycemia are Associated with Poorer Outcomes in COVID-19 Inpatients Without Pre-Existing Diabetes.DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY,14,
MLA:
Lin, Lijin,et al."Newly-Diagnosed Diabetes and Sustained Hyperglycemia are Associated with Poorer Outcomes in COVID-19 Inpatients Without Pre-Existing Diabetes".DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY 14.(2021):4469-4482