tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Na Wu[SUP] 1 [/SUP], Bin Wang[SUP] 2 [/SUP], Yu Xu[SUP] 2 [/SUP], Yao Zhang[SUP] 1 [/SUP], Ying Xiang[SUP] 1 [/SUP], Wenjing Zhang[SUP] 2 [/SUP], Zheng Chen[SUP] 1 [/SUP], Zhiquan Yuan[SUP] 1 [/SUP], Chengying Li[SUP] 1 [/SUP], Xiaoyue Jia[SUP] 1 [/SUP], Yifan Shan[SUP] 1 [/SUP], Bin Xu[SUP] 1 [/SUP], Li Bai[SUP] 2 [/SUP], Li Zhong[SUP] 3 [/SUP], Yafei Li[SUP] 4 [/SUP]
Affiliations
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[SUP]-3[/SUP]). 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.
. 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[SUP] 1 [/SUP], Na Wu[SUP] 1 [/SUP], Bin Wang[SUP] 2 [/SUP], Yu Xu[SUP] 2 [/SUP], Yao Zhang[SUP] 1 [/SUP], Ying Xiang[SUP] 1 [/SUP], Wenjing Zhang[SUP] 2 [/SUP], Zheng Chen[SUP] 1 [/SUP], Zhiquan Yuan[SUP] 1 [/SUP], Chengying Li[SUP] 1 [/SUP], Xiaoyue Jia[SUP] 1 [/SUP], Yifan Shan[SUP] 1 [/SUP], Bin Xu[SUP] 1 [/SUP], Li Bai[SUP] 2 [/SUP], Li Zhong[SUP] 3 [/SUP], Yafei Li[SUP] 4 [/SUP]
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[SUP]-3[/SUP]). 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.