糖尿病和高血糖对首次已知COVID-19感染后短期和长期死亡率的影响

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-03-18 DOI:10.1016/j.diabres.2025.112100

Bruno A. Soto , Ana C. Varella , Marcos R.N. Cavalcante , Carla Romagnolli , Ligia M.G. Fedeli , Gerson S.S. de Oliveira , Isabela M. Bensenor , Alessandra C. Goulart

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引用次数: 0

摘要

目的：评价既往糖尿病和高血糖与covid -19后死亡率的关系。方法：我们评估患有糖尿病的患者（既往糖尿病和使用药物和随机血糖 ≥ 200 mg/dl和HbA1C≥6.5 %或48 mmol/mol）和无糖尿病且在COVID-19前1 年高血糖的患者。计算糖尿病（仅）、糖尿病合并合并症（高血压、慢性肾脏疾病ckd）和无糖尿病但伴有高血糖（≥100 ≥ 110和 ≥ 126 mg/dl）患者的全因死亡率（1周至1年）的风险比（HR）和95 %置信区间（95% %CI）。结果：455例患者中，30.1% %患有糖尿病。糖尿病患者仅在7 天内有高死亡率(HR: 6.24；95 %置信区间:1.03—-37.77)。糖尿病合并高血压和CKD与1周死亡风险增加相关(HR: 7.98；95 %CI, 1.03-61.70)至1年(HR: 2.27；95 %CI: 1.03-4.99)。在没有糖尿病的患者中，FBG≥110和 ≥ 126 mg/dl与COVID-19感染后1年内死亡风险的两倍以上相关[1年HR: 2.80（95 %CI:1.10- 7.22）和1年HR: 2.54(95 %CI:1.10-5.88)]。结论：糖尿病合并其他合并症的患者短期和长期全因死亡风险最高，高血糖是COVID-19感染后预后不良的长期标志。

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The influence of diabetes and hyperglycemia on short and long-term mortality after the first-ever known COVID-19 infection

Aims

To evaluate previous diabetes and hyperglycemia in post-COVID-19 mortality.

Methods

We evaluated patients with diabetes (previous diabetes and use of medication and random glucose ≥ 200 mg/dl and HbA1C ≥ 6.5 % or 48 mmol/mol) and patients without diabetes with hyperglycemia 1 year before COVID-19. Hazard ratios (HR) and 95 % confidence intervals, 95 %CI were calculated for all-cause mortality (1-week to 1-year) among those with diabetes (only), diabetes with comorbidities (hypertension, chronic kidney disease-CKD), and patients without diabetes but with hyperglycemia (≥ 100 ≥ 110 and ≥ 126 mg/dl).

Results

Of 455 patients, 30.1 % had diabetes. Diabetes only had a high mortality risk in 7 days (HR: 6.24; 95 %CI: 1.03–37.77). Diabetes with hypertension and CKD were associated with increased mortality risks from 1-week (HR: 7.98; 95 %CI, 1.03–61.70) to 1-year (HR: 2.27; 95 %CI: 1.03–4.99) after COVID-19. Among those without diabetes, FBG ≥ 110 and ≥ 126 mg/dl were associated with more than double the risk of dying in 1-year after COVID-19 infection [1-year HR: 2.80 (95 %CI: 1.10 – 7.22) and 1-year HR: 2.54 (95 %CI:1.10–5.88), respectively].

Conclusions

Diabetes associated with other comorbidities had the highest risks of all-cause mortality in the short and long-term, hyperglycemia was a long-term marker of poor prognostic after COVID-19 infection.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.