Abstract
Background and aim
To systematically evaluate the associations between glycemic control and short- to long-term outcomes in coronavirus disease 2019 (COVID-19) patients with type 2 diabetes (T2D).
Design and methods
A multi-center prospective cohort study including 574 COVID-19 patients with T2D were conducted in Wuhan, China. All patients were followed-up 1 year after hospital discharge using a uniformed questionnaire including self-reported symptoms, and the chronic obstructive pulmonary disease (COPD) assessment test (CAT) items.
Results
Of the 574 patients, 443 (77.2%) had well-controlled blood glucose. Glycemic control was significantly associated with decreased risk of death (OR: 0.24, 95% CI: 0.10-0.57), ICU admission (OR: 0.22, 95% CI: 0.10-0.49), invasive mechanical ventilation (OR: 0.25, 95% CI: 0.08-0.72), disease progression (OR: 0.25, 95% CI: 0.11-0.55), and composite outcome (OR: 0.26, 95% CI: 0.14-0.49). The top five long-term sequelae include fatigue (31.5%), sweating (21.2%), chest tightness (15.1%), anxiety (12.2%), myalgia (10.6%), and short breath (6.4%). Glycemic control was associated with decreased risk of respiratory sequelae (OR: 0.42, 95% CI: 0.18-0.99, P = 0.048).
Conclusions
Glycemic control was significantly associated with short-term outcomes in COVID-19 patients with T2D, and showed a significant association with long-term respiratory sequelae. The management and control of blood glucose has a positive impact on prognosis of COVID-19.
Keywords: COVID-19, type 2 diabetes, glycemic control, long-term, prognosis
Contributor Information
Kegang Zhan, College of Public Health, Southwest Medical University, Luzhou, Sichuan, China; Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
Xiaohua Zhang, Department of General Surgery, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Bin Wang, Pulmonary and critical care medicine center, Chinese PLA Respiratory Disease Institute, Xinqiao Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Zheng Jiang, Yidu Cloud Technology Co. Ltd, Beijing.
Xiaoyu Fang, College of Public Health, Southwest Medical University, Luzhou, Sichuan, China; Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
Sha Yang, Department of Infectious Diseases, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, P.R. China.
Hong Jia, College of Public Health, Southwest Medical University, Luzhou, Sichuan, China.
Li Li, Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Guoqiang Cao, Department of Respiratory Medicine, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Kejun Zhang, Department of Outpatients, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
Xiangyu Ma, Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China.
Supplementary Material
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