PMID- 32638507
OWN - NLM
STAT- MEDLINE
DCOM- 20210301
LR  - 20220716
IS  - 1753-0407 (Electronic)
IS  - 1753-0393 (Print)
IS  - 1753-0407 (Linking)
VI  - 12
IP  - 12
DP  - 2020 Dec
TI  - The impact of type 2 diabetes and its management on the prognosis of patients 
      with severe COVID-19.
PG  - 909-918
LID - 10.1111/1753-0407.13084 [doi]
AB  - BACKGROUND: Although type 2 diabetes mellitus (T2DM) patients with coronavirus 
      disease 2019 (COVID-19) develop a more severe condition compared to those without 
      diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment 
      with antihyperglycemic drugs and glucocorticoids is unclear. METHODS: From 1584 
      COVID-19 patients, 364 severe/critical COVID-19 patients with clinical outcome 
      were enrolled for the final analysis, and patients without preexisting T2DM but 
      elevated glucose levels were excluded. Epidemiological data were obtained and 
      clinical status evaluation carried out to assess the impact of T2DM and its 
      management on clinical outcomes. RESULTS: Of 364 enrolled severe COVID-19 
      inpatients, 114 (31.3%) had a history of T2DM. Twenty-seven (23.7%) T2DM patients 
      died, who had more severe inflammation, coagulation activation, myocardia injury, 
      hepatic injury, and kidney injury compared with non-DM patients. In severe 
      COVID-19 patients with T2DM, we demonstrated a higher risk of all-cause fatality 
      with glucocorticoid treatment (adjusted hazard ratio [HR], 3.61; 95% CI, 
      1.14-11.46; P = .029) and severe hyperglycemia (fasting plasma glucose 
      >/=11.1 mmol/L; adjusted HR, 11.86; 95% CI, 1.21-116.44; P = .034). CONCLUSIONS: 
      T2DM status aggravated the clinical condition of COVID-19 patients and increased 
      their critical illness risk. Poor fasting blood glucose (>/= 11.1 mmol/L) and 
      glucocorticoid treatment are associated with poor prognosis for T2DM patients 
      with severe COVID-19.
CI  - (c) 2020 Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John 
      Wiley & Sons Australia, Ltd.
FAU - Xu, Zihui
AU  - Xu Z
AUID- ORCID: 0000-0001-7081-3195
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Wang, Zhongjing
AU  - Wang Z
AUID- ORCID: 0000-0002-8684-1200
AD  - Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical 
      College, Huazhong University of Science and Technology, Wuhan, China.
FAU - Wang, Shuo
AU  - Wang S
AUID- ORCID: 0000-0002-4888-7267
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Ye, Yingchun
AU  - Ye Y
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Luo, Deng
AU  - Luo D
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Wan, Li
AU  - Wan L
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Yu, Ailin
AU  - Yu A
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
FAU - Sun, Lifang
AU  - Sun L
AD  - Intensive Care Unit, Renmin Hospital of Wuhan University, Wuhan, China.
FAU - Tesfaye, Solomon
AU  - Tesfaye S
AUID- ORCID: 0000-0003-1190-1472
AD  - Diabetes Research Unit, Sheffield Teaching Hospitals, Royal Hallamshire Hospital, 
      Sheffield, UK.
FAU - Meng, Qingtao
AU  - Meng Q
AUID- ORCID: 0000-0002-1936-3050
AD  - Anesthesiology Department, Renmin Hospital of Wuhan University, Wuhan, China.
FAU - Gao, Ling
AU  - Gao L
AUID- ORCID: 0000-0003-0714-7200
AD  - Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, 
      Wuhan, China.
LA  - eng
GR  - 2017/China Young Scientific Talent Research Fund for diabetes/
GR  - 81571376/National Natural Science Foundation of China/
GR  - 2018/Wuhan Young and Middle-aged Medical Talent Award Plan/
PT  - Journal Article
DEP - 20200816
PL  - Australia
TA  - J Diabetes
JT  - Journal of diabetes
JID - 101504326
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Glucocorticoids)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Aged
MH  - Biomarkers/*analysis
MH  - Blood Glucose/analysis
MH  - COVID-19/complications/*epidemiology/transmission/virology
MH  - China/epidemiology
MH  - Diabetes Mellitus, Type 2/*drug therapy/physiopathology/virology
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - SARS-CoV-2/*isolation & purification
MH  - Survival Rate
PMC - PMC7361557
OTO - NOTNLM
OT  - 2019冠状病毒病
OT  - 2型糖尿病。
OT  - antihyperglycemic drugs
OT  - clinical status
OT  - coronavirus disease 2019 (COVID-19)
OT  - glucocorticoid
OT  - type 2 diabetes
OT  - 临床状况
OT  - 糖皮质激素
OT  - 降糖药
COIS- No conflicts of interest relevant to this article have been reported. The 
      opinions and conclusions of this paper are solely the responsibility of the 
      authors and do not necessarily represent the official positions of the Centers 
      for Disease Control and Prevention.
EDAT- 2020/07/09 06:00
MHDA- 2021/03/02 06:00
PMCR- 2020/08/16
CRDT- 2020/07/09 06:00
PHST- 2020/05/27 00:00 [received]
PHST- 2020/06/28 00:00 [revised]
PHST- 2020/07/03 00:00 [accepted]
PHST- 2020/07/09 06:00 [pubmed]
PHST- 2021/03/02 06:00 [medline]
PHST- 2020/07/09 06:00 [entrez]
PHST- 2020/08/16 00:00 [pmc-release]
AID - JDB13084 [pii]
AID - 10.1111/1753-0407.13084 [doi]
PST - ppublish
SO  - J Diabetes. 2020 Dec;12(12):909-918. doi: 10.1111/1753-0407.13084. Epub 2020 Aug 
      16.