tetano
Editor, Senior Moderator
Front Endocrinol (Lausanne)
. 2020 Jul 10;11:525.
doi: 10.3389/fendo.2020.00525. eCollection 2020.
Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019
Jiaoyue Zhang[SUP] 1 2 [/SUP], Wen Kong[SUP] 1 2 [/SUP], Pengfei Xia[SUP] 3 [/SUP], Ying Xu[SUP] 4 [/SUP], Li Li[SUP] 5 [/SUP], Qin Li[SUP] 6 [/SUP], Li Yang[SUP] 7 [/SUP], Qi Wei[SUP] 8 [/SUP], Hanyu Wang[SUP] 1 2 [/SUP], Huiqing Li[SUP] 1 2 [/SUP], Juan Zheng[SUP] 1 2 [/SUP], Hui Sun[SUP] 1 2 [/SUP], Wenfang Xia[SUP] 1 2 [/SUP], Geng Liu[SUP] 1 2 [/SUP], Xueyu Zhong[SUP] 1 2 [/SUP], Kangli Qiu[SUP] 1 2 [/SUP], Yan Li[SUP] 5 [/SUP], Han Wang[SUP] 1 2 [/SUP], Yuxiu Wang[SUP] 1 2 [/SUP], Xiaoli Song[SUP] 1 2 [/SUP], Hua Liu[SUP] 1 2 [/SUP], Si Xiong[SUP] 4 [/SUP], Yumei Liu[SUP] 7 [/SUP], Zhenhai Cui[SUP] 1 2 [/SUP], Yu Hu[SUP] 9 10 [/SUP], Lulu Chen[SUP] 1 2 [/SUP], An Pan[SUP] 3 [/SUP], Tianshu Zeng[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results: The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.
Keywords: COVID-19; cohort study; coronavirus; diabetes; hyperglycemia; impaired fasting glucose; severe acute respiratory coronavirus 2 (SARS-CoV-2).
. 2020 Jul 10;11:525.
doi: 10.3389/fendo.2020.00525. eCollection 2020.
Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019
Jiaoyue Zhang[SUP] 1 2 [/SUP], Wen Kong[SUP] 1 2 [/SUP], Pengfei Xia[SUP] 3 [/SUP], Ying Xu[SUP] 4 [/SUP], Li Li[SUP] 5 [/SUP], Qin Li[SUP] 6 [/SUP], Li Yang[SUP] 7 [/SUP], Qi Wei[SUP] 8 [/SUP], Hanyu Wang[SUP] 1 2 [/SUP], Huiqing Li[SUP] 1 2 [/SUP], Juan Zheng[SUP] 1 2 [/SUP], Hui Sun[SUP] 1 2 [/SUP], Wenfang Xia[SUP] 1 2 [/SUP], Geng Liu[SUP] 1 2 [/SUP], Xueyu Zhong[SUP] 1 2 [/SUP], Kangli Qiu[SUP] 1 2 [/SUP], Yan Li[SUP] 5 [/SUP], Han Wang[SUP] 1 2 [/SUP], Yuxiu Wang[SUP] 1 2 [/SUP], Xiaoli Song[SUP] 1 2 [/SUP], Hua Liu[SUP] 1 2 [/SUP], Si Xiong[SUP] 4 [/SUP], Yumei Liu[SUP] 7 [/SUP], Zhenhai Cui[SUP] 1 2 [/SUP], Yu Hu[SUP] 9 10 [/SUP], Lulu Chen[SUP] 1 2 [/SUP], An Pan[SUP] 3 [/SUP], Tianshu Zeng[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32754119
- PMCID: PMC7365851
- DOI: 10.3389/fendo.2020.00525
Abstract
Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results: The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.
Keywords: COVID-19; cohort study; coronavirus; diabetes; hyperglycemia; impaired fasting glucose; severe acute respiratory coronavirus 2 (SARS-CoV-2).