Dysglycemias in patients admitted to ICUs with severe acute respiratory syndrome due to COVID-19 versus other causes – A cohort study - Dataset

Dataset of a cohort whose summary is described below.

Abstract

Importance: Dysglycemias have been associated with worse prognosis in critically ill patients with or without diabetes, but data on their association with severe COVID-19 and outcomes are lacking. Objectives: To analyze the relationship of dysglycemias with COVID-19 in hospitalized patients with severe acute respiratory syndrome (SARS) and assess the influence of dysglycemias on mortality. Design, Setting and Participants: Cohort of consecutive patients with SARS and suspected COVID-19 hospitalized in intensive care units (ICUs) across eight hospitals in Curitiba-Brazil. Main Outcomes and Measures: The primary outcome was the influence of COVID-19 on the variation of the following parameters of dysglycemia: highest glucose level at admission, mean and highest glucose levels during ICU stay, mean glucose variation, and percentage of days with hyperglycemia. The secondary outcome was the influence of COVID-19 and each of the five parameters of dysglycemia on hospital mortality within 30 days from ICU admission. Results: We compared 703 patients with COVID-19 and 138 without COVID-19 admitted to the ICUs due to SARS. Compared with patients without COVID-19, those with COVID-19 had significantly higher glucose peaks at admission (198.1mg/dL vs. 167.8mg/dL, respectively) and during ICU stay (285.9mg/Dl vs. 230.9md/dL), higher mean daily glucose values (167.9mg/dL vs. 149.8mg/dL), higher percentage of days with hyperglycemia during ICU stay (vs. 45.0 vs. 31.5), and greater mean daily glucose variations (85.3mg/dL vs. 63.5mg/dL). However, these associations were lost after adjustment for APACHE II scores, SOFA scores, CRP level, corticosteroid use and nosocomial infection. Dysglycemia and COVID-19 were each independent risk factors for mortality. Conclusions and Relevance: Patients with SARS due to COVID-19 had higher mortality and more frequent dysglycemia than patients with SARS due to other causes. This association seemed to be related to disease severity and inflammation and was independent of corticosteroid use, suggesting no specific relationship with the SARS-CoV-2 infection.

本数据集为一项队列研究的相关数据，其概况如下。

摘要

研究背景：糖代谢异常与合并或不合并糖尿病的重症患者不良预后相关，但目前尚缺乏其与重型COVID-19及患者预后关联的相关研究数据。
研究目标：分析合并严重急性呼吸综合征（Severe Acute Respiratory Syndrome, SARS）的住院患者中，糖代谢异常与COVID-19的关联，并评估糖代谢异常对患者病死率的影响。
研究设计、研究场景与研究对象：巴西库里提巴市8家医院重症监护病房（Intensive Care Unit, ICU）内连续收治的、确诊或疑似COVID-19且伴发严重急性呼吸综合征的住院患者队列。
主要结局与测量指标：主要结局为COVID-19对以下糖代谢异常相关参数的影响：入院时最高血糖水平、ICU住院期间的平均血糖与最高血糖水平、平均血糖波动幅度，以及ICU住院期间高血糖症占总住院天数的比例。次要结局为COVID-19及上述5项糖代谢异常参数对ICU入院后30天内住院病死率的影响。
研究结果：本研究共纳入因严重急性呼吸综合征入住ICU的703例COVID-19患者与138例非COVID-19患者。与非COVID-19患者相比，COVID-19患者入院时血糖峰值更高（分别为198.1mg/dL与167.8mg/dL），ICU住院期间的血糖峰值亦更高（285.9mg/dL与230.9mg/dL），日均血糖均值更高（167.9mg/dL与149.8mg/dL），ICU住院期间高血糖症占比天数更高（分别为45.0%与31.5%），且日均血糖波动幅度更大（85.3mg/dL与63.5mg/dL）。但在校正急性生理学与慢性健康状况评分系统II（Acute Physiology and Chronic Health Evaluation II, APACHE II）、序贯器官衰竭评分（Sequential Organ Failure Assessment, SOFA）、C反应蛋白（C-reactive protein, CRP）水平、糖皮质激素使用情况及医院感染后，上述关联均不复存在。糖代谢异常与COVID-19均为患者死亡的独立危险因素。
研究结论与临床意义：相较于其他病因导致严重急性呼吸综合征的患者，COVID-19相关严重急性呼吸综合征患者的病死率更高、糖代谢异常发生率亦更高。该关联似乎与疾病严重程度及炎症反应相关，且不受糖皮质激素使用的影响，提示其与严重急性呼吸综合征冠状病毒2（Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2）感染并无特异性关联。