Fasting blood glucose level is a predictor of mortality in patients with COVID-19 independent of diabetes history

Abstract

Clinical laboratory, and treatment data of inpatients with laboratory-confirmed COVID-19 were collected and analyzed. Outcomes of patients with and without pre-existing diabetes were compared. The associations of diabetes history and/or FBG levels with mortality were analyzed. Multivariate cox regression analysis on the risk factors associated with mortality in patients with COVID-19 was performed. Results: A total of 941 hospitalized patients with COVID-19 were enrolled in the study. There was a positive relationship between pre-existing diabetes and the mortality of patients who developed COVID-19 (21 of 123 [17.1%] vs 76 of 818 [9.3%]; P = 0.012). FBG !7.0 mmol/L was an independent risk factor for the mortality of COVID-19 regardless of the presence or not of a history of diabetes (hazard ratio, 2.20 [95% CI, 1.21-4.03]; P = 0.010). Conclusions: We firstly showed FBG !7.0 mmol/L predicted worse outcome in hospitalized patients with COVID-19 independent of diabetes history. Our findings indicated screening FBG level is an effective method to evaluate the prognosis of patients with COVID-19.

Prognostic value of fasting hyperglycemia in patients with COVID-19 – Diagnostic test accuracy meta-analysis

“…There were 9045 patients from 12 studies included in this systematic review and meta-analysis [ Fig. 1 ] ( Cai et al, 2020 ; Chen et al, 2021 ; Coppelli et al, 2020 ; Deng et al, 2020 ; Gastélum-Cano et al, 2021 ; Huh et al, 2020 ; Li et al, 2020 ; Liu et al, 2020 ; Sardu et al, 2020 ; Sun et al, 2020 ; Wang et al, 2020 ; Zhang et al, 2020 ). Baseline characteristics of the included studies are presented in Table 1 .…”

“…Diabetes, especially newly diagnosed diabetes ( Sathish et al, 2021a ), has been shown to increase mortality in patients with COVID-19 ( Huang et al, 2020a ; Shrestha et al, 2021 ) Individual studies have studied the association between fasting hyperglycemia and poor outcomes in COVID-19 patients ( Cai et al, 2020 ; Chen et al, 2021 ; Coppelli et al, 2020 ; Li et al, 2020 ; Liu et al, 2020 ; Wang et al, 2020 ); most showing a positive association, while a few have not ( Gastélum-Cano et al, 2021 ). In patients with diabetes, hyperglycemia may also represent a glycemic poor control, in addition to the acute stress caused by infection.…”

Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning

“…Hyperglycemia on hospital admission in severely ill people with COVID-19 is very well recognized and is predictive of a poor outcome, even in subjects without pre-existing diabetes ( Cai et al., 2020 ; Fadini et al., 2020 ; Huang et al., 2020b ; Mamtani et al., 2020a ). For example, dysregulated glucose control was associated with poor outcomes in 1,122 hospitalized people with COVID-19 analyzed in the Glytec database from March 1 to April 6, 2020 ( Bode et al., 2020 ).…”

On-admission parameters based prognostication in COVID-19: an important missing link…

“…The lack of presentation of the blood glucose levels in the index study captivates attention, particularly when there is an accumulating literature on the prognostic role of the on-admission hyperglycaemia in COVID-19 regardless of the diabetic status of the diseased subset [ [2] , [3] , [4] ]. In this context, a systematic review and dose-response meta analysis by Lazarus et al (comprising of 35 studies and a total of 14,502 patients) reveal a 33% accentuation in the risk of COVID-19 disease severity for every 1 mmol/L increase in the on-admission fasting blood glucose [ 2 ].…”