Diabetes Care:COVID-19住院的1型糖尿病患者入住重症监护病房、机械通气和死亡率分析

2021-06-23 MedSci原创 MedSci原创

因COVID-19住院的T1DM患者发生严重结局的风险高于非糖尿病患者。T1DM患者ICU/MV的风险高于T2DM患者的主要原因是伴有DKA。这些结果可进一步指导糖尿病治疗和COVID-19预防。

糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,该研究旨在评估因COVID-19住院的1型糖尿病(T1DM)患者与无糖尿病或2型糖尿病(T2DM)患者严重结局的风险是否不同。

研究人员使用COVID-19数据库,收集了2020年3月至11月美国医院因COVID-19住院患者的数据(排除后N=269674),研究人员估计了T1DM患者与非糖尿病或T2DM患者在入住重症监护病房或有创机械通气(ICU/MV)和死亡的风险差异(RD)和风险比(RR)。Logistic模型根据年龄、性别和种族或民族进行了调整。根据其他人口统计学和临床特征调整的模型用于评估其他因素是否可以解释T1DM和严重COVID-19患者预后之间的关联。

与非糖尿病患者相比,T1DM患者ICU/MV的绝对风险增加21% (RD为0.21, 95%CI为0.19-0.24;RR为1.49,95%CI为1.43-1.56),绝对死亡风险增加5% (RD为0.05, 95%CI为0.03-0.07;RR为1.40,95%CI为1.24-1.57),并根据年龄、性别和种族或民族进行调整。

主要结局比较

与T2DM相比,T1DM患者发生ICU/MV的绝对风险增加9% (RD为0.09, 95%CI为0.07-0.12;RR为1.17, 95%CI为1.12-1.22),但死亡率无差异(RD为0.00, 95%CI为-0.02至0.02;RR为1.00, 95%CI为0.89-1.13)。在对COVID-19诊断前或诊断时发生的糖尿病酮症酸中毒(DKA)进行调整后,与T2DM患者相比,T1DM患者的ICU/MV风险不再增加(RD为0.01, 95%CI为-0.01至0.03),死亡率也有所降低(RD为-0.03,95%CI为-0.05至-0.01)。

由此可见,因COVID-19住院的T1DM患者发生严重结局的风险高于非糖尿病患者。T1DM患者ICU/MV的风险高于T2DM患者的主要原因是伴有DKA。这些结果可进一步指导糖尿病治疗和COVID-19预防
 
原始出处:
 
Catherine E. Barrett,et al.Intensive Care Unit Admission, Mechanical Ventilation, and Mortality Among Patients With Type 1 Diabetes Hospitalized for COVID-19 in the U.S.Diabetes care.2021.https://doi.org/10.2337/dc21-0604

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    2021-06-25 bioon6
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    2021-06-24 misszhang

    谢谢MedSci提供最新的资讯

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1761624, encodeId=1c931e616248d, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 11 02:12:49 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1968322, encodeId=fdf31968322ea, content=<a href='/topic/show?id=a4b96e542' target=_blank style='color:#2F92EE;'>#1型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=675, encryptionId=a4b96e542, topicName=1型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Wed Aug 11 05:12:49 CST 2021, time=2021-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902582, encodeId=40bd1902582da, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Thu Apr 07 01:12:49 CST 2022, time=2022-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639790, encodeId=cf7a1639e901d, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Thu Apr 21 04:12:49 CST 2022, time=2022-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1368859, encodeId=b1fc136885994, content=<a href='/topic/show?id=3d849596588' target=_blank style='color:#2F92EE;'>#重症监护病房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95965, encryptionId=3d849596588, topicName=重症监护病房)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4a4d285, createdName=日月, createdTime=Fri Jun 25 14:12:49 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475089, encodeId=433314e508991, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Fri Jun 25 14:12:49 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551203, encodeId=ec3315512032f, content=<a href='/topic/show?id=e2c1e230796' target=_blank style='color:#2F92EE;'>#监护#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72307, encryptionId=e2c1e230796, topicName=监护)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=477814173963, createdName=bioon6, createdTime=Fri Jun 25 14:12:49 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043664, encodeId=09f8104366433, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Jun 24 02:12:49 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976380, encodeId=f1df9e638049, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Wed Jun 23 23:34:54 CST 2021, time=2021-06-23, status=1, ipAttribution=)]
    2021-06-23 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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