糖尿病合并COVID-19患者的临床特征及严重程度的危险因素

Clinical features and risk factors of disease severity on diabetes patients with COVID-19

目的:分析糖尿病合并新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)患者临床特征及严重程度的危险因素.方法:回顾性分析2020年2月至2020年4月武汉火神山医院收治的80例糖尿病合并COVID-19患者的临床资料,总结其临床特征.根据患者的临床分型,分为轻症组(普通型患者)、重症组(重型和危重型患者),比较两组间基本资料、实验室指标的差异,分析患者病情严重程度的影响因素.结果:80例患者中,男49例,女31例,平均年龄为65.2岁.普通型25例,重型37例,危重型18例.好转出院61例,死亡19例.胸部CT检查,感染明显者54例(67.50%).实验室检查:血白蛋白降低、空腹血糖升高、C-反应蛋白升高、淋巴细胞数减少、D-二聚体升高患者的比例分别为86.25%、81.25%、67.50%、55.00%、53.75%.轻症组(25例)与重症组(55例)比较,在吸烟史、合并高血压、白细胞数、血小板数、C-反应蛋白、乳酸脱氢酶、尿素氮、白蛋白等方面差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示,合并高血压(OR=3.431,95%CI为1.134~10.38,P=0.029)、血小板数减少(OR=0.990,95%CI为0.984~0.997,P=0.004)是患者病情严重程度的独立危险因素.结论:糖尿病合并COVID-19患者中重症比例高、预后差;合并高血压和血小板数减少与病情严重程度相关.

Objective:To retrospectively explore the clinical features and risk factors of disease severity on diabetes patients with COVID-19.Methods:The clinical datas of diabetes patients with COVID-19 admitted to Huoshenshan Hospital in Wuhan from February 2020 to April 2020 were collected.The clinical characteristics of the patients were analyzed.According to the clinical classification of patients,the patients were divided into mild group(ordinary type patient)and severe group(severe type and critical type patient).The differences of each index between the two groups were compared and the risk factors related to severity of disease were analyzed.Results:Of the 80 patients,49 were males and 31 were females,with average age of 65.2 years.There were 25 common type patients,37 severe type patients and 18 critical type patients.61 cases were discharged after treatment and 19 cases died.Chest CT examination showed obvious infection in 54 cases(67.50%).Laboratory tests showed that rate of patients with decreased serum albumin,increased fasting blood glucose,increased C-reactive protein,decreased lymphocyte number and increased D-dimer were 86.25%,81.25%,67.50%,55.00%,53.75%respectively.There were significant differences in smokers,hypertension,white blood cell count,platelet count,c-reactive protein,lactate dehydrogenase,urea nitrogen and albumin between the mild group(25 cases)and the severe group(55 cases)(P<0.05).Multivariate logistic regression analysis showed that hypertension(OR=3.431,95%CI 1.134-10.38,P=0.029)and platelet count(OR=0.990,95%CI 0.984-0.997,P=0.004)were independent risk factors related to the severity of disease.Conclusion:Diabetes patients with COVID-19 have a high rate of severe and poor prognosis.Hypertension and platelet count are independent risk factors related to the severity of disease.