BMC infectious diseases · 2021
Critically ill patients with diabetes and Middle East respiratory syndrome: a multi-center observational study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Jose Jesna, Al-Dorzi Hasan M, Al-Omari Awad, Mandourah Yasser, Al-Hameed Fahad, Sadat Musharaf, Al Qasim Eman, Alraddadi Basem, Al Harthy Abdulrahman, Al Mekhlafi Ghaleb A, Almotairi Abdullah, Al Khatib Kasim, Abdulmomen Ahmed, Qushmaq Ismael, Sindi Anees A, Mady Ahmed, Solaiman Othman, Al-Raddadi Rajaa, Maghrabi Khalid, Ragab Ahmed, Kharaba Ayman, Shalhoub Sarah, Al-Aithan Abdulsalam M, Vishwakarma Gajendra K, Bhattacharjee Atanu, Arabi Yaseen M, Saudi Critical Care Trials Group
Аннотация
BACKGROUND: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS).
METHODS: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality.
RESULTS: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p < 0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72).
CONCLUSIONS: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.
METHODS: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality.
RESULTS: Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p < 0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72).
CONCLUSIONS: Half of the critically ill patients with MERS have diabetes; which is associated with more severe disease. Diabetes is an independent predictor of mortality among critically patients with MERS.
Предметные рубрики MeSH
Adrenal Cortex HormonesAdultAge FactorsAgedBronchoalveolar Lavage FluidCohort StudiesComorbidityCoronavirus InfectionsCritical IllnessDiabetes ComplicationsDiabetes MellitusFemaleHumansMaleMiddle AgedMiddle East Respiratory Syndrome CoronavirusNasopharynxRespiratory InsufficiencyRetrospective StudiesRisk FactorsSaudi ArabiaSputumTrachea