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Baseline moderate-range albuminuria is associated with protection against severe COVID-19 pneumonia

World Journal of Diabetes 2022年第12期13卷 1154-1167页

作者： amir bashkin Mona Shehadeh Lina Shbita Kamil Namoura Ronza Haiek Elena Kuyantseva Yousef Boulos Orly Yakir Etty Kruzel-Davila Department of Diabetes Endocrinologyand MetabolismGalilee Medical CenterNahariya 2210001Israel Azrieli Faculty of Medicine Bar-Ilan UniversityZefat 1311502Israel Clinical Laboratories Division Clinical Biochemistry and Endocrinology LaboratoryGalilee Medical CenterNahariya 2210001Israel Internal Medicine A Galilee Medical CenterNahariya 2210001Israel Statistical Analysis Division Galilee Medical CenterNahariya 2210001Israel Department of Nephrology Galilee Medical CenterNahariya 2210001Israel

BACKGROUND Diabetes mellitus is considered a leading contributor to severe coronavirus disease 2019(COVID-19).AIM To characterize differences between hospitalized diabetic patients with vs without COVID-19,and parameters associated with COVID-19 severity for *** This case-control study included 209 patients with type 2 diabetic mellitus hospitalized at the Galilee Medical Center(Nahariya,Israel)and recruited between September 2020 and May 2021,65 patients with COVID-19 infection in dedicated wards and 144 COVID-19-negative patients in internal medicine wards hospitalized due to other *** parameters-including age,type of antiglycemic medications,presence of retinopathy,smoking history,body mass index(BMI),glycosylated hemoglobin,maximum neutrophil:lymphocyte ratio(NLR_(max)),C-reactive protein(CRP),estimated glomerular filtration rate(eGFR),and albumin(blood and urine)-were compared between the two primary patient groups,and then between COVID-19-negative patients hospitalized due to infectious vs non-infectious ***,we explored which parameters were associated with severe COVID-19 *** COVID-19-negative patients were older(63.9±9.9 vs 59.8±9.2,P=0.005),and had longer duration of diabetes(P=0.031),lower eGFR(P=0.033),higher albumin(P=0.026),lower CRP(P<0.001),greater smoking prevalence(P<0.001),and more baseline albuminuria(54.9%vs 30.8%,P=0.005)at admission;70%of COVID-19 patients with albuminuria had moderate-range albuminuria(albumin:creatinine 30-300 mg/g).Most of the patients with albuminuria had chronic kidney disease stage II(CKD II).Oral antiglycemic therapies were not significantly different between the two *** logistic regression showed that higher BMI was significantly associated with severe COVID-19(OR 1.24,95%CI:1.01-1.53,P=0.04),as was higher NLR_(max)(OR 1.2,95%CI:1.06-1.37,P=0.005).Surprisingly,pre-hospitalization albuminuria,mostly moderate-range,was associated with reduced risk(OR

关键词： Diabetes mellitus COVID-19 Albuminuria Severity Chronic kidney disease Immunomodulation

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