新型冠状病毒肺炎与2型糖尿病炎性风暴特质的交互影响

Interaction between novel coronavirus pneumonia and the inflammatory storm characteristics of type 2 diabetes mellitus

目的 通过比较新型冠状病毒肺炎(COVID-19)患者伴或不伴2型并糖尿病(T2DM)的炎症指标、凝血功能及疾病转归的差异,讨论COVID-19合并2型糖尿病患者的炎性特质及其相互影响。方法 回顾性纳入2022年12月至2023年4月于太原市人民医院住院治疗确诊为COVID-19的轻型或普通型患者311例,其中T2DM组115例,选取同时段就诊的与之匹配的非糖尿病患者(对照组)196例。比较2组患者血细胞分析、炎症指标、凝血功能等实验室指标及核酸转阴时间、住院时间、是否使用激素等临床资料的差异。结果 T2DM组淋巴细胞计数水平低于对照组,中性粒细胞计数、C反应蛋白高于对照组(P<0.05);T2DM组D-二聚体显著升高(P<0.05);T2DM组核酸转阴时间及住院时间更长,使用激素者更多。结论 糖尿病是COVID-19发生的高危因素,新型冠状病毒感染增加了糖尿病患者的血糖调控难度。糖尿病合并COVID-19更容易发生“炎性风暴”,对患者的预后有严重的影响,住院时间更长,死亡风险大。

Objective To compare the inflammatory markers,coagulation function,and disease outcomes of COVID-19 patients with or without type 2 diabetes and discuss the inflammatory characteristics and their interaction in COVID-19 patients with type 2 diabetes.Methods A retrospective study was conducted on a total of 311 hospitalized patients with mild or moderate COVID-19 at Taiyuan People′s Hospital from December 2022 to April 2023.The study included 115 patients in the type 2 diabetes group(T2DM group) and a matched control group consisting of 196 non-diabetic patients who received medical treatment during the same period.Blood cell analysis,inflammation index,coagulation function,other laboratory indicators as well as nucleic acid negative time were compared between the two groups.Clinical data such as hospital stay and use of hormones were also analyzed.Results The lymphocyte count was lower while neutrophil count and C-reactive protein levels were higher in the diabetic group compared to the control group(P<0.05).D-dimer levels were significantly increased in the diabetic group(P<0.05).The duration of negative nucleic acid test results and hospital stay were longer in the diabetic group along with a higher usage rate of hormones.Conclusion Diabetes is a high-risk factor for COVID-19 infection which further complicates blood glucose regulation in diabetic patients.The combination of diabetes and COVID-19 increases susceptibility to an "inflammatory storm," leading to worse prognosis including prolonged hospital stays and increased risk of death.