新型冠状病毒肺炎患者合并糖尿病的临床特点及预后

Clinical features and prognosis of patients with novel coronavirus pneumonia complicated with diabetes

目的:分析新型冠状病毒(COVID-19)患者的临床及实验室检查的特征并比较合并糖尿病(DM)对COVID-19患者的影响及预后。方法:回顾性队列研究分析2020年1月31日~2020年3月15日于武汉大学人民医院收治的56例合并DM的COVID-19患者和年龄匹配的85例非合并DM的COVID-19患者。通过电子病例收集患者的资料,使用SPSS 26.0和Graphpad Prism 8.0统计软件比较DM组和非DM组患者的各项指标变化,并绘制生存曲线。结果:与非DM组相比,DM组机械通气比例和病死率更高,初始症状中恶心、合并高血压、重症比例更高(P<0.05),两组间性别、初始症状(除恶心外)、合并基础疾病(除高血压)均无统计学差异(P>0.05);DM组的白细胞、中心粒细胞计数、CRP、PT、PCT、D-二聚体、总胆红素、Urea、LDH、MB、CK、CK-MB、hs-TnI、NT-proBNP偏高(P<0.05),淋巴细胞、单核细胞、CD3、CD4、CD8计数偏低(P<0.05),两组间血小板、IL-6、APTT、ALT、AST、Cr、CD19计数无统计学差异。结论:与非DM合并COVID-19的患者相比,DM合并COVID-19的患者病死率、重症比例更高,心功能、肝肾功能、免疫功能损伤及凝血功能障碍更加明显,因此应加强对此类患者的监护,积极治疗从而改善预后。

Objective: To analyze the clinical characteristics and laboratory examinations of patients with Coronavirus Disease 2019(COVID-19)and to compare the effect and prognosis of patients with diabetes mellitus(DM)on COVID-19.Methods: This retrospective cohort study analyzed 56 cases of COVID-19 complicated with DM and 85 age-matched admitted patients without DM who were admitted to the People's Hospital of Wuhan University from January 31,2020 to March 15,2020.Patients data were collected through electronic cases,and SPSS 26.0 and Graphpad Prism 8.0 statistical software were used to compare changes in various indicators of patients in DM and non-DM groups and to draw the survival curves.Results: Compared with the non-DM group,the DM group had a higher percentage of mechanical ventilation,higher mortality and severe patients,with a higher proportion of initial symptoms of nausea and hypertension(P<0.05).There were no significant differences in the gender,initial symptoms(except nausea)and the combined underlying diseases(except hypertension)between the two groups(P<0.05).The white blood cell,centroblast count,CRP,PCT,PT,D-dimer,total bilirubin,urea,LDH,CK,MB,hs-TnI,CK-MB,NT-proBNP were higher in the DM group(P<0.05),and lymphocytes,single nuclear cell,CD3,CD4,and CD8 counts were low(P<0.05).There was no statistically significant difference in platelet,IL-6,APTT,ALT,AST,Cr and CD19 counts between the two groups.Conclusion: Compared with COVID-19 patients with non-DM,COVID-19 patients with DM have a higher proportion of mortality and severe cases.Heart function,liver and kidney function,immune function damage and coagulation dysfunction are more obvious.Therefore,the monitoring of such patients should be strengthened,and active treatment should be performed to improve the prognosis.