I. Stulin, M. Oca, G. Blanco, L. Sanchez, Isabel Marcolino da Silva, J. Quevedo, M. C. Arvelo, N. Valera, I. Papa, F. D. Abreu, H. Villarroel, J. C. Catari, J. López, B. Moran, C. Cárdenas, S. Santucci, J. Viloria, J. G. C. Gomez, A. Martinelli, E. García, M. Guzman
{"title":"COVID-19住院患者血糖水平的临床特征:病例系列","authors":"I. Stulin, M. Oca, G. Blanco, L. Sanchez, Isabel Marcolino da Silva, J. Quevedo, M. C. Arvelo, N. Valera, I. Papa, F. D. Abreu, H. Villarroel, J. C. Catari, J. López, B. Moran, C. Cárdenas, S. Santucci, J. Viloria, J. G. C. Gomez, A. Martinelli, E. García, M. Guzman","doi":"10.22209/IC.v62s2a03","DOIUrl":null,"url":null,"abstract":"Hyperglycemia, with or without diabetes, is associated with complications in hospitalized patients with COVID-19. There is no information regarding this problem in our region. This study was aimed to compare the characteristics and in-hospital clinical course of patients with a probable diagnosis of COVID-19, with and without hyperglycemia during the hospitalization. This is a retrospective, observational study of clinical records review of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data collection. Hyperglycemia was defined as a fasting value >= 140 mg/dL according to standard glycaemia targets in hospitalized patients. A total of 148 patients were included, 97 (65.5%) men and 51 (34.5%) women, with a mean age of 64.1 +/- 16.1 years;of which 42/148 (28.4%) patients reported previous diabetes, 60/148 (40.5%) patients had hyperglycemia during the hospitalization and 32/60 (53.3%) of these cases did not report previous diabetes. The patients with hyperglycemia were older, received more frequently systemic corticosteroids (96.6 vs 82.6%;p=0.01), and antibiotics (68.3 vs 44.3%;p=0.01), had worse baseline oxygenation parameters (SpO(2) 88.1 +/- 1,1.7%;vs 92.8 +/- 5.5%;p=0.02, PaO2/FiO(2), 194.4 +/- 119.7 vs 270.9 +/- 118.3;p<0.001), higher total lung severity score in the chest CT (14.9 +/- 5.7 vs 11.1 +/- 6.3;p<0.001) and higher levels of baseline inflammatory markers (CRP 6.73 +/- 3.61 vs 5.08 +/- 4.21;p<0.01, LDH 342.9 +/- 118.4 vs 296.5 +/- 161.4;p=0.01 and Ferritin 687.7 +/- 373.2 vs 542.6 +/- 395.3;p=0.01). Mortality (34.5 vs 10.7%;p<0.001) and admission to ICU (43.3 vs 7.9%;p<0.001) were higher in patients with hyperglycemia. Hyperglycemia in hospitalized patients with COVID-19 is a marker of severe disease and poor prognosis.","PeriodicalId":14514,"journal":{"name":"Investigacion clinica","volume":" ","pages":""},"PeriodicalIF":0.1000,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Caracterización clínica, según niveles de glucemia, de pacientes hospitalizados por COVID-19: serie de casos\",\"authors\":\"I. Stulin, M. Oca, G. Blanco, L. Sanchez, Isabel Marcolino da Silva, J. Quevedo, M. C. Arvelo, N. Valera, I. Papa, F. D. Abreu, H. Villarroel, J. C. Catari, J. López, B. Moran, C. Cárdenas, S. Santucci, J. Viloria, J. G. C. Gomez, A. Martinelli, E. García, M. Guzman\",\"doi\":\"10.22209/IC.v62s2a03\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Hyperglycemia, with or without diabetes, is associated with complications in hospitalized patients with COVID-19. There is no information regarding this problem in our region. This study was aimed to compare the characteristics and in-hospital clinical course of patients with a probable diagnosis of COVID-19, with and without hyperglycemia during the hospitalization. This is a retrospective, observational study of clinical records review of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data collection. Hyperglycemia was defined as a fasting value >= 140 mg/dL according to standard glycaemia targets in hospitalized patients. A total of 148 patients were included, 97 (65.5%) men and 51 (34.5%) women, with a mean age of 64.1 +/- 16.1 years;of which 42/148 (28.4%) patients reported previous diabetes, 60/148 (40.5%) patients had hyperglycemia during the hospitalization and 32/60 (53.3%) of these cases did not report previous diabetes. The patients with hyperglycemia were older, received more frequently systemic corticosteroids (96.6 vs 82.6%;p=0.01), and antibiotics (68.3 vs 44.3%;p=0.01), had worse baseline oxygenation parameters (SpO(2) 88.1 +/- 1,1.7%;vs 92.8 +/- 5.5%;p=0.02, PaO2/FiO(2), 194.4 +/- 119.7 vs 270.9 +/- 118.3;p<0.001), higher total lung severity score in the chest CT (14.9 +/- 5.7 vs 11.1 +/- 6.3;p<0.001) and higher levels of baseline inflammatory markers (CRP 6.73 +/- 3.61 vs 5.08 +/- 4.21;p<0.01, LDH 342.9 +/- 118.4 vs 296.5 +/- 161.4;p=0.01 and Ferritin 687.7 +/- 373.2 vs 542.6 +/- 395.3;p=0.01). Mortality (34.5 vs 10.7%;p<0.001) and admission to ICU (43.3 vs 7.9%;p<0.001) were higher in patients with hyperglycemia. 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引用次数: 0
摘要
COVID-19住院患者的高血糖伴或不伴糖尿病与并发症有关。我们的环境中没有关于这个问题的信息。本研究的目的是比较在住院期间出现高血糖或未出现高血糖的COVID-19患者的特点和住院临床病程。这是一项回顾性、观察性研究,回顾COVID-19住院患者的临床病史。使用ISARIC和世卫组织开发的表格收集数据。根据住院患者的标准血糖目标,它被定义为高血糖,空腹值等于或大于140 mg/ dL。我们纳入148例患者,男性97例(65.5%),女性51例(34.5%),平均年龄64.1±16.1岁,其中42例(28.4%)有糖尿病史,60例(40.5%)有住院高血糖史,32例(53.3%)无糖尿病史。高血糖患者年龄较大,全身皮质类固醇治疗较多(96.6 vs 82.6%;p= 0.01),抗生素(68.3 vs 44.3%;p= 0.01),进入氧合变化较大(SpO2 88.1±11.7% vs 92.8±5.5%,p= 0.02;PaO2/FiO2, 1940.4±119.7 vs 270.9±118.3,p< 0.001),胸部ct肺损伤扩展评分较高(14.9±5.7 vs 11.1±6.3;p< 0.001)和炎症标志物改变最多(crp 6.73±3.61 vs 5.08±4.21;p< 0.01, LDH 342.9±118.4 vs 296.5±161.4;p= 0.01,铁蛋白687.7±373.2 vs 542.6±395.3;p = 0.01)。死亡率(34.5 vs 10.7%;p< 0.001)和icu入院(43.3 vs 7.9%;p< 0.001)在高血糖患者中较高。COVID-19住院患者的高血糖是最严重和预后差的标志。
Caracterización clínica, según niveles de glucemia, de pacientes hospitalizados por COVID-19: serie de casos
Hyperglycemia, with or without diabetes, is associated with complications in hospitalized patients with COVID-19. There is no information regarding this problem in our region. This study was aimed to compare the characteristics and in-hospital clinical course of patients with a probable diagnosis of COVID-19, with and without hyperglycemia during the hospitalization. This is a retrospective, observational study of clinical records review of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data collection. Hyperglycemia was defined as a fasting value >= 140 mg/dL according to standard glycaemia targets in hospitalized patients. A total of 148 patients were included, 97 (65.5%) men and 51 (34.5%) women, with a mean age of 64.1 +/- 16.1 years;of which 42/148 (28.4%) patients reported previous diabetes, 60/148 (40.5%) patients had hyperglycemia during the hospitalization and 32/60 (53.3%) of these cases did not report previous diabetes. The patients with hyperglycemia were older, received more frequently systemic corticosteroids (96.6 vs 82.6%;p=0.01), and antibiotics (68.3 vs 44.3%;p=0.01), had worse baseline oxygenation parameters (SpO(2) 88.1 +/- 1,1.7%;vs 92.8 +/- 5.5%;p=0.02, PaO2/FiO(2), 194.4 +/- 119.7 vs 270.9 +/- 118.3;p<0.001), higher total lung severity score in the chest CT (14.9 +/- 5.7 vs 11.1 +/- 6.3;p<0.001) and higher levels of baseline inflammatory markers (CRP 6.73 +/- 3.61 vs 5.08 +/- 4.21;p<0.01, LDH 342.9 +/- 118.4 vs 296.5 +/- 161.4;p=0.01 and Ferritin 687.7 +/- 373.2 vs 542.6 +/- 395.3;p=0.01). Mortality (34.5 vs 10.7%;p<0.001) and admission to ICU (43.3 vs 7.9%;p<0.001) were higher in patients with hyperglycemia. Hyperglycemia in hospitalized patients with COVID-19 is a marker of severe disease and poor prognosis.