Importance of hyperglycemia in COVID-19 intensive-care patients: Mechanism and treatment strategy

Mirzaei, Fatemeh; Khodadadi, Iraj; Vafaei, Seyyed Alireza; Abbasi-Oshaghi, Ebrahim; Tayebinia, Heidar; Farahani, Farhad

doi:10.1016/j.pcd.2021.01.002

Cited by 36 publications

(38 citation statements)

References 51 publications

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“…Hence, strict control of blood glucose levels is considered essential. 19 Moreover, diabetes medications, such as sodium-glucose cotransporter-2 inhibitors, increase angiotensin-converting enzyme 2 in the kidney, and osmotic diuresis, dehydration and euglycaemic diabetic ketoacidosis are known side effects limiting the use of these agents to control high blood glucose levels in patients with COVID-19, especially in those admitted to the intensive care unit. 20 Our study used a comprehensive EHR database to include a large and representative sample of patients with T2D in Israel, with detailed data available on risk factors before COVID-19 infection.…”

mentioning

confidence: 99%

Preinfection glycaemic control and disease severity among patients with type 2 diabetes and COVID‐19: A retrospective, cohort study

Hayek

Ben‐Shlomo

Balicer

et al. 2021

Diabetes Obesity Metabolism

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Type 2 diabetes (T2D) is one of the most common and important risk factors for severe health outcomes related to coronavirus disease-2019 (COVID-19). [1][2][3] Data from the French Coronavirus SARS-CoV-2 and Diabetes Outcomes (CORONADO) study in patients with COVID-19 infection showed that higher body mass index (BMI) and complications of diabetes were associated with disease severity and death, but they did not identify a link between glycaemic control and mortality. 4,5 However, other studies found an association between HbA1c level and COVID-19-related death, 6-8 suggesting poor glycaemic control as a potential risk factor for mortality.

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mentioning

confidence: 99%

Preinfection glycaemic control and disease severity among patients with type 2 diabetes and COVID‐19: A retrospective, cohort study

Hayek

Ben‐Shlomo

Balicer

et al. 2021

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…In intensive care patients with COVID disease, several factors may exacerbate hyperglycaemia and insulin resistance, in primis bed rest, medications (i.e. vasopressors and corticosteroids) and systemic inflammatory activation [23]. We also assessed glucose variability which itsefl is affected by hyperglycemia, insulin resistance, disease severity and also by management, thus being considered a modifiable factor.…”

Section: Discussionmentioning

confidence: 99%

The prognostic role of hyperglycemia and glucose variability in covid-related acute respiratory distress Syndrome

Lazzeri

Bonizzoli

Batacchi

et al. 2021

Diabetes Research and Clinical Practice

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Due to heterogeneity on the prognostic role of glucose values and glucose variability in Novel Coronavirus (COVID) disease, we aimed at assessing the prognostic role for Intensive Care Unit (ICU) death of admission hyperglycaemia, peak glycemia and glucose variability in critically ill COVID patients: Methods: 83 patients consecutively admitted for COVID-related Acute Respiratory Distress Syndrome (ARDS) from from 1st March to 1st October 2020. Results: Non survivors were older, with more comorbidities and a more severe disease. Corticosteroids were used in the majority of patients (54/83, 65%) with no difference between survivors and non survivors. Mean blood glucose values, (during the first 24 and 48 h, respectively), were comparable between the two subgroups, as well as SD 24 and CV 24.During the first 48 h, survivors showed significantly lower values of SD 48 (p < 0.001) and CV 48, respectively (p < 0.001) than non survivors. Conclusions: in consecutive COVID-related ARDS patients admitted to ICU hyperglycemia (>180 mg/dl) is more common in non survivors who also showed a significantly higher glucose variability in the first 48 h since ICU admission. Our findings point to the clinical significance of in-ICU glucose control in severe COVID patients.

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“…In summary, diabetic patients may have high susceptibility to viral pneumonia. Hyperglycemia can increase the risk of lung abnormalities including reduced lung aspiratory function, increased pulmonary microangiopathy, impaired lung structure, reduced immunity, and increased oxidative stress (OS) [ 25 , 28 , 29 ].…”

Section: Diabetes and Viral Respiratory Infectionsmentioning

confidence: 99%

Diabetes and COVID-19: Mechanism of pneumonia, treatment strategy and vaccine

et al. 2021

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As of August 5, 2021, there were about 200,000,000 global confirmed patients of COVID-19, with more than 4,250,000 deaths. The COVID-19 disease which is a tremendous public health threat, jumps unpredictably and outbreaks very quickly. The overall mortality rate of COVID-19 infection is 1%–15% but reaches up to 17–38% in older cases with chronic disorders and in intensive care unit (ICU) subjects. Diabetic patients, particularly those whose disease is not well controlled can be more susceptible to COVID-19. Although diabetes was present in 5.3%–42.3% of fatalities from COVID-19, the underlying pathophysiological mechanisms of action of novel coronavirus in diabetic patients are unknown. Based on the elevating of global prevalence, diabetes is the main medical problem associated with COVID-19. It is plausible that diabetes can forecast elevated severity of pneumonia. The mortality of lung infection among diabetes is remarkably higher compared with non-diabetic patients. Mechanisms responsible for severe pneumonia in the diabetic patients as well as treatment of diabetic patients infected with COVID-19 are largely speculative. Hence, this paper will summarize the recent findings related to the mechanisms of pneumonia and treatment strategies in diabetic patients.

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Importance of hyperglycemia in COVID-19 intensive-care patients: Mechanism and treatment strategy

Cited by 36 publications

References 51 publications

Preinfection glycaemic control and disease severity among patients with type 2 diabetes and COVID‐19: A retrospective, cohort study

Preinfection glycaemic control and disease severity among patients with type 2 diabetes and COVID‐19: A retrospective, cohort study

The prognostic role of hyperglycemia and glucose variability in covid-related acute respiratory distress Syndrome

Diabetes and COVID-19: Mechanism of pneumonia, treatment strategy and vaccine

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