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Diabetes Res Clin Pract
. 2021 Sep 6;109041.
doi: 10.1016/j.diabres.2021.109041. Online ahead of print.
Fasting plasma glucose and glucose fluctuation are associated with COVID-19 prognosis regardless of pre-existing diabetes
Weijia Xie 1 , Na Wu 1 , Bin Wang 2 , Yu Xu 2 , Yao Zhang 1 , Ying Xiang 1 , Wenjing Zhang 2 , Zheng Chen 1 , Zhiquan Yuan 1 , Chengying Li 1 , Xiaoyue Jia 1 , Yifan Shan 1 , Bin Xu 1 , Li Bai 2 , Li Zhong 3 , Yafei Li 4
Affiliations
- PMID: 34500004
- DOI: 10.1016/j.diabres.2021.109041
Abstract
Aims: We aimed to investigate the role of Fasting Plasma Glucose (FPG) and glucose fluctuation in the prognosis of COVID-19 patients stratified by pre-existing diabetes.
Methods: The associations of FPG and glucose fluctuation indexes with prognosis of COVID-19 in 2,642 patients were investigated by multivariate Cox regression analysis. The primary outcome was in-hospital mortality; the secondary outcome was disease progression. The longitudinal changes of FPG over time were analyzed by the latent growth curve model in COVID-19 patients stratified by diabetes and severity of COVID-19.
Results: We found FPG as an independent prognostic factor of overall survival after adjustment for age, sex, diabetes and severity of COVID-19 at admission (HR: 1.15, 95% CI: 1.06-1.25, P=1.02×10-3). Multivariate logistic regression analysis indicated that the standard deviation of blood glucose (SDBG) and largest amplitude of glycemic excursions (LAGE) were also independent risk factors of COVID-19 progression (P=0.03 and 0.04, respectively). The growth trajectory of FPG over the first 3 days of hospitalization was steeper in patients with critical COVID-19 in comparison to moderate patients.
Conclusions: Hyperglycemia and glucose fluctuation were adverse prognostic factors of COVID-19 regardless of pre-existing diabetes. This stresses the importance of glycemic control in addition to other therapeutic management.
Keywords: COVID-19; Diabetes; blood glucose fluctuation; coronavirus; fasting plasma glucose.