Hyperglycemia and insulin resistance in COVID-19 versus non-COVID critical illness: Are they really different?

Langouche, Lies; Berghe, Greet Van den; Gunst, Jan

doi:10.1186/s13054-021-03861-6

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…Patients with COVID-19, without any pre-existing history or diagnosis of diabetes, are reported to have a greater prevalence of hyperglycemia 7 . However, stress hyperglycemia and insulin resistance are also characteristics of other acute critical illnesses 8 . Therefore, it remains unclear whether COVID-19-associated hyperglycemia and insulin resistance is more severe than in non-COVID patients with similar disease severity.…”

Section: Introductionmentioning

confidence: 99%

Diabetes and COVID-19: Short- and Long-Term Consequences

et al. 2022

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When the corona pandemic commenced more than two years ago, it was quickly recognized that people with metabolic diseases show an augmented risk of severe COVID-19 and an increased mortality compared to people without these comorbidities. Furthermore, an infection with SARS-CoV-2 has been shown to lead to an aggravation of metabolic diseases and in single cases to new-onset metabolic disorders. In addition to the increased risk for people with diabetes in the acute phase of COVID-19, this patient group also seems to be more often affected by long-COVID and to experience more long-term consequences than people without diabetes. The mechanisms behind these discrepancies between people with and without diabetes in relation to COVID-19 are not completely understood yet and will require further research and follow-up studies during the following years. In the current review, we discuss why patients with diabetes have this higher risk of developing severe COVID-19 symptoms not only in the acute phase of the disease but also in relation to long-COVID, vaccine breakthrough infections and re-infections. Furthermore, we discuss the effects of lockdown on glycemic control.

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Section: Introductionmentioning

confidence: 99%

Diabetes and COVID-19: Short- and Long-Term Consequences

et al. 2022

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“…Reasons for this new-onset hyperglycemia upon COVID-19 hospitalization are many folds, including previously undiagnosed diabetes, usage of non-diabetic medications, and stress-induced transient rise in blood sugar levels ( 22 ). Besides, SARS-CoV-2 might attack the ACE2-expressed pancreatic islets to impair the endocrine balance, and the ensuing insulin deficiency/resistance could cause hyperglycemia as other non-COVID-19 critical illness did ( 23 , 24 ).…”

Section: Resultsmentioning

confidence: 99%

Effect of Comorbid Diabetes on Clinical Characteristics of COVID-19 Patients Infected by the Wild-Type or Delta Variant of SARS-CoV-2

Zhang

Tao

2022

Front. Endocrinol.

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BackgroundDiabetes is one of the most common comorbidities in COVID-19 patients that pertains to disease severity, but the causal mechanism regarding its negative impact on COVID-19 outcome has yet been uncovered.MethodsWe retrospectively analyzed 459 COVID-19 patients admitted in early 2020 and 336 COVID-19 patients admitted in August 2021, with their demographic information, medical history, vaccination status (if applied), and laboratory data reported.ResultsAmong COVID-19 patients, compared to the non-diabetic group, the diabetic group exhibited elder age, higher proportion of patients with other major comorbidities, more severe dysfunction of innate immune cells, more refractory blood coagulopathy and more detrimental organ damage. For the wild-type SARS-CoV-2 infection, diabetic comorbidity was associated with COVID-19 severity but not mortality, and the glycemic levels in the non-diabetic group upon infection experienced high and analogous to those in the diabetic group. Besides, infected by the delta variant of SARS-CoV-2, the non-diabetic patients did not demonstrate hyperglycemia, and despite different vaccination statuses, the diabetic patients exhibited comparable antibody responses to non-diabetic, showing the robustness of acquired immunity.ConclusionsSARS-CoV-2 infection may superimpose the deterioration of innate immune systems in diabetic patients, which contributes to their worsened disease outcome, but timely COVID-19 immunization could provide adequate protection in diabetic population that leads to favored prognosis.

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“…Likewise, COVID-19 predisposes infected patients to hyperglycemia, diabetic ketoacidosis, and new-onset diabetes [ 28 ]. This can lead to an endless loop of worsening hyperglycemia and COVID-19 infection [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Stress Hyperglycemia Ratio as a Prognostic Marker in Diabetic Patients Hospitalized with COVID-19

Aon

Alsaeedi

Alzafiri

et al. 2022

Infectious Disease Reports

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Evidence is conflicting about the diabetes characteristics associated with worse outcome among hospitalized COVID-19 patients. We aimed to assess the role of stress hyperglycemia ratio (SHR) as a prognostic marker among them. In our retrospective cohort study, patients were stratified according to SHR, admission glucose, and glycated hemoglobin tertiles. The primary outcome was a composite endpoint of invasive mechanical ventilation, intensive care unit admission, and in-hospital mortality. The study included 395 patients with a mean age of 59 years, and 50.1% were males. Patients in the third tertile of SHR developed more primary events, and the difference was significant compared to the first tertile (p = 0.038) and close to significance compared to the second tertile (p = 0.054). There was no significant difference in the outcomes across admission glucose and glycated hemoglobin tertiles. A higher SHR tertile was an independent risk factor for the primary outcome (OR, 1.364; 95% CI: 1.014–1.836; p = 0.040) after adjustment for other covariables. In hospitalized COVID-19 diabetic patients, SHR third tertile was significantly associated with worse outcome and death. SHR can be a better prognostic marker compared to admission glucose and glycated hemoglobin. A higher SHR was an independent risk factor for worse outcome and in-hospital mortality.

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Hyperglycemia and insulin resistance in COVID-19 versus non-COVID critical illness: Are they really different?

Cited by 16 publications

References 15 publications

Diabetes and COVID-19: Short- and Long-Term Consequences

Diabetes and COVID-19: Short- and Long-Term Consequences

Effect of Comorbid Diabetes on Clinical Characteristics of COVID-19 Patients Infected by the Wild-Type or Delta Variant of SARS-CoV-2

Stress Hyperglycemia Ratio as a Prognostic Marker in Diabetic Patients Hospitalized with COVID-19

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