PDF(Pubmed)
Abstract：
OBJECTIVE: Serum amyloid A (SAA) is an acute phase reactive protein that plays a vital role in the early diagnosis, risk prediction, efficacy observation and prognosis evaluation of infectious diseases. This study aimed to assess the association between SAA levels and the prognosis of patients with coronavirus disease 2019 (COVID-19) and diabetes.
METHODS: We carried out this retrospective cohort study from March 2022 to May 2022. The population was stratified by tertiles of SAA levels: low (<8.5 mg/L), medium (8.5-36 mg/L) and high (>36 mg/L). The primary outcome was whether the patient developed severe COVID-19, and secondary outcomes included the need for invasive mechanical ventilation and length of hospital stay. Logistic regression analyses were carried out to identify risk factors affecting the prognosis of patients with COVID-19 and diabetes.
RESULTS: We analyzed 910 diabetes patients with COVID-19. The median age of the patients was 69 years, and 52.3% were men. As SAA levels increased, the proportion of severe COVID-19 (6.3% vs 7.3% vs 22.8%, P < 0.001) and the proportion of invasive mechanical ventilation also increased among the three groups. Patients with high SAA levels had a longer length of hospital stay compared with patients with medium SAA and low SAA levels. Univariate logistic regression analysis showed that SAA >36 mg/L further increased the odds ratio to 4.423 (P < 0.001) for the development of severe COVID-19 compared with low SAA. Multivariate logistic regression analysis, adjusted for age and sex, confirmed that SAA >36 mg/L remained an independent risk factor for the development of severe COVID-19 (adjusted odds ratio 3.038, P < 0.001).
CONCLUSIONS: SAA levels are strongly associated with poor prognosis in patients with COVID-19 and diabetes.
METHODS: We carried out this retrospective cohort study from March 2022 to May 2022. The population was stratified by tertiles of SAA levels: low (<8.5 mg/L), medium (8.5-36 mg/L) and high (>36 mg/L). The primary outcome was whether the patient developed severe COVID-19, and secondary outcomes included the need for invasive mechanical ventilation and length of hospital stay. Logistic regression analyses were carried out to identify risk factors affecting the prognosis of patients with COVID-19 and diabetes.
RESULTS: We analyzed 910 diabetes patients with COVID-19. The median age of the patients was 69 years, and 52.3% were men. As SAA levels increased, the proportion of severe COVID-19 (6.3% vs 7.3% vs 22.8%, P < 0.001) and the proportion of invasive mechanical ventilation also increased among the three groups. Patients with high SAA levels had a longer length of hospital stay compared with patients with medium SAA and low SAA levels. Univariate logistic regression analysis showed that SAA >36 mg/L further increased the odds ratio to 4.423 (P < 0.001) for the development of severe COVID-19 compared with low SAA. Multivariate logistic regression analysis, adjusted for age and sex, confirmed that SAA >36 mg/L remained an independent risk factor for the development of severe COVID-19 (adjusted odds ratio 3.038, P < 0.001).
CONCLUSIONS: SAA levels are strongly associated with poor prognosis in patients with COVID-19 and diabetes.
摘要：
目的：血清淀粉样蛋白A（SAA）是一种急性期反应蛋白，在早期诊断中起着至关重要的作用，风险预测，感染性疾病的疗效观察及预后评价。这项研究旨在评估SAA水平与2019年冠状病毒病（COVID-19）和糖尿病患者预后之间的关系。
方法：我们从2022年3月至2022年5月进行了这项回顾性队列研究。按SAA水平的三位数对人群进行分层：低（<8.5mg/L），中等（8.5-36毫克/升）和高（>36毫克/升）。主要结果是患者是否出现严重COVID-19，次要结果包括需要有创机械通气和住院时间。Logistic回归分析影响COVID-19合并糖尿病患者预后的危险因素。
结果：我们分析了910名患有COVID-19的糖尿病患者。患者的中位年龄为69岁，男性占52.3%。随着SAA水平的升高,重症COVID-19的比例（6.3%vs7.3%vs22.8%，P<0.001），有创机械通气的比例在三组中也有所增加。与SAA水平中等和SAA水平低的患者相比，SAA水平高的患者住院时间更长。单因素logistic回归分析显示，SAA>36mg/L与低SAA相比，重症COVID-19的比值比进一步增加至4.423（P<0.001）。多因素Logistic回归分析，根据年龄和性别调整，证实SAA>36mg/L仍然是发展为重度COVID-19的独立危险因素(校正比值比3.038,P<0.001)。
结论：SAA水平与COVID-19和糖尿病患者的不良预后密切相关。
方法：我们从2022年3月至2022年5月进行了这项回顾性队列研究。按SAA水平的三位数对人群进行分层：低（<8.5mg/L），中等（8.5-36毫克/升）和高（>36毫克/升）。主要结果是患者是否出现严重COVID-19，次要结果包括需要有创机械通气和住院时间。Logistic回归分析影响COVID-19合并糖尿病患者预后的危险因素。
结果：我们分析了910名患有COVID-19的糖尿病患者。患者的中位年龄为69岁，男性占52.3%。随着SAA水平的升高,重症COVID-19的比例（6.3%vs7.3%vs22.8%，P<0.001），有创机械通气的比例在三组中也有所增加。与SAA水平中等和SAA水平低的患者相比，SAA水平高的患者住院时间更长。单因素logistic回归分析显示，SAA>36mg/L与低SAA相比，重症COVID-19的比值比进一步增加至4.423（P<0.001）。多因素Logistic回归分析，根据年龄和性别调整，证实SAA>36mg/L仍然是发展为重度COVID-19的独立危险因素(校正比值比3.038,P<0.001)。
结论：SAA水平与COVID-19和糖尿病患者的不良预后密切相关。
