COVID-19(症状性非呼吸系统)合并2型糖尿病

Nursin Abdul Kadir, I. Parwati
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摘要

COVID-19是一种由新型冠状病毒-严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的呼吸道感染,主要通过呼吸道飞沫和接触具有高度传染性。典型症状包括发烧、咳嗽和呼吸短促。虚弱、恶心和呕吐常伴有呼吸道症状,但有时会混淆这些症状是否没有呼吸道症状。COVID-19可影响任何年龄组,在成人和男性中更为常见,并在患有合并症的患者中增加。最常见的合并症之一是糖尿病(DM)。男,40岁,主诉发热、虚弱3天。入院前9天开始恶心和呕吐,伴有吞咽疼痛、胃灼热和食欲下降。在去医院前14天有出城和朋友吃饭的记录3.3实验室检查结果:白细胞6600个/mm,血小板26.4万个/mm, NLR 2.3,血糖209 mg/dL,糖化血红蛋白8.6%,SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2反应,中医SARS-CoV-2阳性(N2 Ct 18, E Ct 20.3), RT-PCR SARS-CoV-2结果阴性转化时间为19 d。SARS-CoV-2病毒不仅感染肺细胞,还通过糖尿病患者的ACE2受体感染胃肠道、胰腺和内皮细胞,导致细胞壁对外来病原体的渗透性增加,并在胃肠道内膜细胞中进行病毒复制。随后肠细胞侵袭引起吸收不良,导致肠道症状。不受控制的血糖状况可以减缓病毒的脱落,因此RT-PCR SARS-CoV-2结果的阴性转化长度延长。基于上述数据,该患者的诊断为COVID-19(症状性非呼吸性)合并2型糖尿病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 (Symptomatic Non-Respiratory) with Type 2 Diabetes Mellitus
COVID-19 is a respiratory infection caused by a new strain of Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is highly contagious, primarily through respiratory droplets and contact. Typical symptoms include fever, cough, and shortness of breath. Weakness, nausea, and vomiting are often accompanied by respiratory symptoms but are sometimes confusing when these symptoms occur without respiratory symptoms. COVID-19 can affect any age group, are more common in adults and males and increase in patients with comorbidities. One of the most common comorbidities is Diabetes Mellitus (DM). A 40-year-old male patient complained of fever and weakness for three days. Nausea and vomiting since nine days before hospital admission, accompanied by painful swallowing, heartburn, and decreased appetite. History of going out of town and eating with friends 14 days before access to the hospital. 3 3 Laboratory examination results: 6600 leukocytes/mm , 264,000/mm platelets, NLR 2.3, 209 mg/dL of blood glucose, HbA1C 8.6%, SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2 reactive, positive TCM SARS-CoV-2 (N2 Ct 18 and E Ct 20.3), and the duration of negative conversion of RT-PCR SARS-CoV-2 results was 19 days. The SARS-CoV-2 virus not only infects pneumocytes but also gastrointestinal, pancreatic, and endothelial cells via ACE2 receptors in DM patients, causing increased cell wall permeability to foreign pathogens and viral replication in the gastrointestinal lining cells. Subsequent enterocyte invasion causes malabsorption resulting in enteric symptoms. Uncontrolled glycemia conditions can slow viral shedding, so the length of negative conversion of RT-PCR SARS-CoV-2 results is prolonged. Based on the data above, the diagnosis in this patient was COVID-19 (symptomatic non-respiratory) with type 2 DM.
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