Admission fasting blood glucose predicts 30‐day poor outcome in patients hospitalized for <scp>COVID</scp>‐19 pneumonia

Zhang, Bin; Liu, Shuyi; Zhang, Lu; Dong, Yang; Zhang, Shuixing

doi:10.1111/dom.14132

Cited by 29 publications

(22 citation statements)

References 18 publications

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“…However, in this scenario, it should be considered also the possible diabetogenic effect of SARS-CoV2 due to its direct action on key metabolic organs, including the β-cell, and resulting in new-onset hyperglycemia or sudden deterioration of pre-existing diabetes, beyond the well-recognized stress response associated with severe illness [ 41 ]. Three recent reports showed that fasting blood glucose at admission, irrespective of previous diagnosis of diabetes, was an independent predictor of critical illness [ 42 ], death [ 43 ], or poor outcome [ 44 ] in patients hospitalized with COVID-19.…”

Section: Mechanisms Linking Diabetes To Covid-19mentioning

confidence: 99%

Is diabetes mellitus a risk factor for COronaVIrus Disease 19 (COVID-19)?

et al. 2020

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The COronaVirus DISease 19 (COVID-19) is a pandemic infectious disease caused by the novel coronavirus Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2). Older age and presence of comorbidities, including diabetes, were shown to be associated with a more severe course and a higher fatality rate. Studies from the most affected countries, including China, United States and Italy, seem to indicate that prevalence of diabetes among patients affected by COVID-19 is not higher than that observed in the general population, thus suggesting that diabetes is not a risk factor for SARS-CoV-2 infection. However, a large body of evidence demonstrate that diabetes is a risk factor for disease progression towards critical illness, development of acute respiratory distress syndrome, need for mechanical ventilation or admission to intensive care unit, and ultimately death. The mechanisms underlying the relationship between COVID-19 and diabetes remain to be elucidated. In particular, it is still unresolved whether is diabetes per se, especially if poorly controlled, or rather the various comorbidities/complications associated with it that predispose patients with COVID-19 to a worse prognosis. In fact, conditions that cluster with diabetes in the context of the metabolic syndrome, such as obesity and hypertension, or complicate chronic hyperglycemia, such as cardiovascular disease and chronic kidney disease, have also been associated with poor prognosis in these individuals and the available studies have not consistently shown that diabetes predict disease severity independently of them. Electronic supplementary material The online version of this article (10.1007/s00592-020-01586-6) contains supplementary material, which is available to authorized users.

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Section: Mechanisms Linking Diabetes To Covid-19mentioning

confidence: 99%

Is diabetes mellitus a risk factor for COronaVIrus Disease 19 (COVID-19)?

et al. 2020

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“…Diabetes is associated with an increased risk of developing pneumonia, 1,2 including its viral forms. 3,4 Patients with diabetes experience higher mortality after pneumonia compared with patients without diabetes. 5 In addition, diabetes has been recognized as a risk factor for the development of severe pneumonia and death because of 2019 coronavirus disease (COVID-19).…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes is associated with an increased risk of developing pneumonia, 1,2 including its viral forms 3,4 . Patients with diabetes experience higher mortality after pneumonia compared with patients without diabetes 5 .…”

Section: Introductionmentioning

confidence: 99%

Exposure to dipeptidyl‐peptidase 4 inhibitors and the risk of pneumonia among people with type 2 diabetes: Retrospective cohort study and meta‐analysis

Morieri

Bonora

Longato

et al. 2020

Diabetes Obesity Metabolism

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Aim Concerns have been raised that dipeptidyl‐peptidase 4 inhibitors (DPP‐4i) may increase the risk of pneumonia. We analysed observational data and clinical trials to explore whether use of DPP‐4i modifies the risk of pneumonia. Methods We identified patients with diabetes in the Veneto region administrative database and performed propensity score matching between new users of DPP‐4 inhibitors and new users of other oral glucose‐lowering medications (OGLMs). We compared the rate of hospitalization for pneumonia between matched cohorts using the Cox proportional hazard model. The same analysis was repeated using the database of a local diabetes outpatient clinic. We retrieved similar observational studies from the literature to perform a meta‐analysis. Results from trials reporting pneumonia rates among patients randomized to DPP‐4 inhibitors versus placebo/active comparators were also meta‐analysed. Results In the regional database, after matching 6495 patients/group, new users of DPP‐4 inhibitors had a lower rate of hospitalization for pneumonia than new users of other OGLMs (HR 0.76; 95% CI 0.61‐0.95). In the outpatient database, after matching 867 patients/group, new users of DPP‐4 inhibitors showed a non‐significantly lower rate of hospitalization for pneumonia (HR 0.65; 95% CI 0.41‐1.04). The meta‐analysis of observational studies yielded an overall non‐significant lower risk of hospitalization for pneumonia among DPP‐4 inhibitor users (RR 0.81; 95% CI 0.65‐1.01). The meta‐analysis of randomized controlled trials showed no overall effect of DPP‐4 inhibitors on pneumonia risk (RR 1.06; 95% CI 0.93‐1.20). Conclusion The use of DPP‐4 inhibitors can be considered as safe with regard to the risk of pneumonia.

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“…[28][29][30] Other potential mechanisms include the possibility that COVID-19 virus has a high affinity for human ACE2 (receptors highly expressed in adipose tissue), and obesityrelated comorbidities may aggravate pneumonia. [31][32][33][34][35]…”

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confidence: 99%

Obese COVID‐19 patients show more severe pneumonia lesions on CT chest imaging

Luo

Jiaerken

Shen

et al. 2020

Diabetes Obesity Metabolism

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The COVID-19 epidemic will persist for the foreseeable future. Given the significant toll the outbreak has taken on the healthcare system, identifying those patients with a greater need for medical attention is necessary. Recent studies suggest that obesity is associated with worse severity of COVID-19 pneumonia, increasing the need for hospitalization, critical care and mechanical ventilation. 1-6 T A B L E 1 Demographics, medical history, laboratory and pneumonia involvement (mm 3) for the four BMI groups Variables Normal weight Overweight Obese Underweight F/χ 2 value P (n = 84, 36.4%) (n = 105, 45.4%) (n = 33, 14.3%) (n = 9, <0.1%) Age, years

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Admission fasting blood glucose predicts 30‐day poor outcome in patients hospitalized for COVID‐19 pneumonia

Cited by 29 publications

References 18 publications

Is diabetes mellitus a risk factor for COronaVIrus Disease 19 (COVID-19)?

Is diabetes mellitus a risk factor for COronaVIrus Disease 19 (COVID-19)?

Exposure to dipeptidyl‐peptidase 4 inhibitors and the risk of pneumonia among people with type 2 diabetes: Retrospective cohort study and meta‐analysis

Obese COVID‐19 patients show more severe pneumonia lesions on CT chest imaging

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