tetano
Editor, Senior Moderator
Cureus
. 2022 Aug 2;14(8):e27611.
doi: 10.7759/cureus.27611. eCollection 2022 Aug.
Hyperglycemia in Severe and Critical COVID-19 Patients: Risk Factors and Outcomes
Viet Tran Le[SUP] 1 [/SUP], Quoc Hung Ha[SUP] 1 [/SUP], Minh Triet Tran[SUP] 2 [/SUP], Ngoc Trong Le[SUP] 1 [/SUP], Van Tuyen Le[SUP] 1 [/SUP], Minh Khoi Le[SUP] 3 1 [/SUP]
Affiliations
Abstract
Background: Hyperglycemia is commonly seen in critically ill patients. This disorder was also seen in coronavirus disease 2019 (COVID-19) patients and was associated with a worse prognosis. The current study determined the prevalence, risk factors, and prognostic implications of hyperglycemia in COVID-19 patients.
Method: This was a retrospective observational study performed in an intensive care unit for COVID-19 patients. Electronic data of COVID-19 patients admitted to the intensive care unit from August 2nd to October 15th, 2021, were collected. Patients were divided into non-hyperglycemia, hyperglycemia in diabetic patients, and hyperglycemia in non-diabetic patients. Primary outcomes were 28-day and in-hospital mortalities. Multinomial logistic regression and multivariable Cox regression models were used to determine the risk factors for hyperglycemia and mortality, respectively.
Results: Hyperglycemia was documented in 65.6% of patients: diabetic patients (44.8%) and new-onset hyperglycemia (20.8%). In-hospital and 28-day mortality rates were 30.2% and 26.1%, respectively. Respiratory failure, corticosteroid therapy, and a higher level of procalcitonin were risk factors for hyperglycemia in diabetic patients, whereas cardiovascular diseases, respiratory failure, and higher aspartate aminotransferase/glutamate aminotransferase ratio were risk factors for hyperglycemia in non-diabetic patients. The risk of the 28-day mortality rate was highest in the new-onset hyperglycemia (hazard ratio
3.535, 95% confidence interval [CI] 1.338-9.338, p=0.011), which was higher than hyperglycemia in type 2 diabetes mellitus patients (HR 1.408, 95% CI 0.513-3.862, p=0.506).
Conclusion: Hyperglycemia was common in COVID-19 patients in the intensive care unit. Hyperglycemia reflected the disease severity but was also secondary to therapeutic intervention. New-onset hyperglycemia was associated with poorer outcomes than that in diabetic patients.
Keywords: corticosteroid; covid-19; diabetes; hyperglycemia; intensive care.
. 2022 Aug 2;14(8):e27611.
doi: 10.7759/cureus.27611. eCollection 2022 Aug.
Hyperglycemia in Severe and Critical COVID-19 Patients: Risk Factors and Outcomes
Viet Tran Le[SUP] 1 [/SUP], Quoc Hung Ha[SUP] 1 [/SUP], Minh Triet Tran[SUP] 2 [/SUP], Ngoc Trong Le[SUP] 1 [/SUP], Van Tuyen Le[SUP] 1 [/SUP], Minh Khoi Le[SUP] 3 1 [/SUP]
Affiliations
- PMID: 35949446
- PMCID: PMC9356651
- DOI: 10.7759/cureus.27611
Abstract
Background: Hyperglycemia is commonly seen in critically ill patients. This disorder was also seen in coronavirus disease 2019 (COVID-19) patients and was associated with a worse prognosis. The current study determined the prevalence, risk factors, and prognostic implications of hyperglycemia in COVID-19 patients.
Method: This was a retrospective observational study performed in an intensive care unit for COVID-19 patients. Electronic data of COVID-19 patients admitted to the intensive care unit from August 2nd to October 15th, 2021, were collected. Patients were divided into non-hyperglycemia, hyperglycemia in diabetic patients, and hyperglycemia in non-diabetic patients. Primary outcomes were 28-day and in-hospital mortalities. Multinomial logistic regression and multivariable Cox regression models were used to determine the risk factors for hyperglycemia and mortality, respectively.
Results: Hyperglycemia was documented in 65.6% of patients: diabetic patients (44.8%) and new-onset hyperglycemia (20.8%). In-hospital and 28-day mortality rates were 30.2% and 26.1%, respectively. Respiratory failure, corticosteroid therapy, and a higher level of procalcitonin were risk factors for hyperglycemia in diabetic patients, whereas cardiovascular diseases, respiratory failure, and higher aspartate aminotransferase/glutamate aminotransferase ratio were risk factors for hyperglycemia in non-diabetic patients. The risk of the 28-day mortality rate was highest in the new-onset hyperglycemia (hazard ratio
3.535, 95% confidence interval [CI] 1.338-9.338, p=0.011), which was higher than hyperglycemia in type 2 diabetes mellitus patients (HR 1.408, 95% CI 0.513-3.862, p=0.506).
Conclusion: Hyperglycemia was common in COVID-19 patients in the intensive care unit. Hyperglycemia reflected the disease severity but was also secondary to therapeutic intervention. New-onset hyperglycemia was associated with poorer outcomes than that in diabetic patients.
Keywords: corticosteroid; covid-19; diabetes; hyperglycemia; intensive care.