Dysglycemia after COVID-19 pneumonia: a six-month cohort study

Abstract

Aim The aim of this study was to understand whether the dysglycemia associated with SARS-CoV-2 infection persists or reverts when the viral infection resolves. Methods We analyzed fasting blood glucose (FBG) after hospital discharge in a cohort of 621 adult cases with suspected COVID-19 pneumonia. Results At admission, 18.8% of the patients in our cohort had pre-existing diabetes, 9.3% fasting glucose in the diabetes range without a prior diagnosis (DFG), 26% impaired fasting glucose (IFG), 44.9% normal fasting glucose (NFG), while 2% had no FBG available. FBG categories were similarly distributed in the 71 patients without confirmed COVID-19 pneumonia. During follow-up (median time 6 month) FBG was available for 321 out of the 453 (70.9%) surviving patients and showed a trend to a marginal increase [from 97 (87-116) to 100 (92-114) mg/dL; p = 0.071]. Transitions between FBG categories were analyzed in subjects without pre-existing diabetes (265 out of 321). We identified three groups: (i) patients who maintained or improved FBG during follow-up [Group A, n = 185; from 100 (86-109) to 94 (88-99) mg/dL; p < 0.001]; (ii) patients who moved from the NFG to IFG category [Group B, n = 66: from 89 (85-96) to 106 (102-113) mg/dl; p < 0.001]; (iii) patients who maintained or reached DFG during follow-up [Group C, n = 14: from 114 (94-138) to 134 (126-143) mg/dl; p = 0.035]. Male sex and ICU admission during the hospitalization were more prevalent in Group C compared to Group A or B. Conclusions Six months after the SARS-CoV-2 infection DFG was evident in only few patients who experienced severe COVID-19 pneumonia.

No Evidence of Long-Term Disruption of Glycometabolic Control After SARS-CoV-2 Infection

“…Informed consent was obtained by all participants according to Institutional Review Board guidelines. A confirmed COVID-19 case was defined as previously described ( 33 ). Briefly, a patient with SARS-CoV-2 positive reverse-transcriptase polymerase chain reaction (rtPCR) from a nasal/throat swab and signs, symptoms, and radiological findings suggestive of COVID-19 pneumonia was classified as positive (n = 558).…”

“…Demographic information, clinical features, and laboratory tests were obtained within 72 h from admission. Data were collected as previously described ( 33 ) during hospitalization or after discharge from both structured baseline patient interviews and hospital paper or electronic medical records. We also reviewed the electronic medical records in the year prior to the hospital admission for COVID-19.…”

Effect of elevated fasting blood glucose level on the 1‐year mortality and sequelae in hospitalized COVID‐19 patients: A bidirectional cohort study

“…In terms of the stratification of FBG levels in nondiabetic COVID‐19 patients, most research used dichotomy (<7.0 and ≥7.0 mmol/L), some used trichotomy (<6.1, 6.1−7.0, and ≥7.0 mmol/L), 2 while few studies focused on further stratification of FBG. 7 Based on the criteria of the American Diabetes Association (ADA) and World Health Organization (WHO), 8 , 9 FBG in the prediabetic status is defined as 5.6−6.9 and 6.1−6.9 mmol/L, respectively. Therefore, in this investigation, we divided admission FBG into four levels in COVID‐19 patients without a diabetic history (≤5.5, 5.6−6.0, 6.1−6.9, and ≥7.0 mmol/L) and three levels in COVID‐19 patients with a diabetic history (≤6.1, 6.1−6.9, and ≥7.0 mmol/L), so as to investigate the effect of FBG on 1‐year mortality, sequelae, and pulmonary absorption in hospitalized COVID‐19 patients with and without diabetic history, respectively.…”

“…On the other hand, few studies report the dynamic changes of FBG in COVID‐19 patients during hospitalization and its predictive effect on their long‐term prognosis. 9 To observe the impact of SARS‐CoV‐2 infection on FBG and avoid the possible confounding factors of diabetes on FBG, we divided COVID‐19 patients into the diabetic history group and nondiabetic history group, analyzed the dynamic changes of FBG in patients with different admission FBG levels, and compared the level of FBG in the survival and death cases to study the impact of FBG level on the long‐term prognosis in the two groups.…”

“…Therefore, in this investigation, we divided admission FBG into four levels in COVID‐19 patients without a diabetic history (≤5.5, 5.6−6.0, 6.1−6.9, and ≥7.0 mmol/L) and three levels in COVID‐19 patients with a diabetic history (≤6.1, 6.1−6.9, and ≥7.0 mmol/L), so as to investigate the effect of FBG on 1‐year mortality, sequelae, and pulmonary absorption in hospitalized COVID‐19 patients with and without diabetic history, respectively. On the other hand, few studies report the dynamic changes of FBG in COVID‐19 patients during hospitalization and its predictive effect on their long‐term prognosis 9 . To observe the impact of SARS‐CoV‐2 infection on FBG and avoid the possible confounding factors of diabetes on FBG, we divided COVID‐19 patients into the diabetic history group and nondiabetic history group, analyzed the dynamic changes of FBG in patients with different admission FBG levels, and compared the level of FBG in the survival and death cases to study the impact of FBG level on the long‐term prognosis in the two groups.…”