tetano
Editor, Senior Moderator
J Diabetes Investig
. 2020 Oct 9.
doi: 10.1111/jdi.13431. Online ahead of print.
Glycemic control prior to admission is an important determinant of prognosis in patients with Coronavirus Disease 2019
Li Liu[SUP] 1 [/SUP], Wang Wei[SUP] 2 [/SUP], Kun Yang[SUP] 3 [/SUP], Shengzhong Li[SUP] 4 [/SUP], Xuefeng Yu[SUP] 1 [/SUP], Chen Dong[SUP] 5 [/SUP], Benping Zhang[SUP] 1 [/SUP]
Affiliations
Abstract
Aim: This study aimed to explore the association between glycemic control prior to admission with severity and mortality of COVID-19, and tried to reveal the mechanism.
Methods: 77 inpatients were grouped into sufficient control group (HbA1c<6.5%, n=49) and insufficient control group (HbA1c ≥ 6.5%, n=28). Regression models were used to analyze the clinical data.
Results: Compared with patients with HbA1C < 6.5, patients with HbA1C ≥ 6.5 showed higher heart rate (101 vs. 89 beats per min, P=0.012), lower percutaneous oxygen saturation (93% vs. 97%, P=0.001), higher levels of multiple indicators of inflammation, such as white blood cell count (7.9 vs. 5.9 ?10⁹/L, P=0.019), neutrophil count (6.5 vs. 4.1 ?10⁹/L, P=0.001), high-sensitivity C-reactive protein (52 vs. 30 mg/L, P=0.025), and serum ferritin (1287 vs. 716 μg/L, P=0.023), as well as lower level of lymphocyte count (0.7 vs. 0.8 ?10⁹/L P=0.049) at hospital admission. Thus, patients with HbA1C ≥ 6.5 were more likely to develop secondary respiratory infections (25 [89%] vs. 33 [67%], P=0.032) and acute respiratory distress syndrome (ARDS) (17 [61%] vs. 14 [29%], P=0.006) than patients with HbA1C < 6.5, resulting in a higher proportion of critically ill cases (19 [68%] vs. 18 [37%], P=0.009) and non-survivors (13 [46%] vs. 11 [22%], P=0.029). After adjustment for potential risk factors, HbA1C was independently associated with in-hospital death.
Conclusion: HbA1c was an independent risk factor for poor outcomes in COVID-19 patients. Severe pulmonary infection and consequent ARDS might be the primary causes of death in insufficient glycemic control patients.
Keywords: Coronavirus Disease 2019; glycemic control; prognosis.
. 2020 Oct 9.
doi: 10.1111/jdi.13431. Online ahead of print.
Glycemic control prior to admission is an important determinant of prognosis in patients with Coronavirus Disease 2019
Li Liu[SUP] 1 [/SUP], Wang Wei[SUP] 2 [/SUP], Kun Yang[SUP] 3 [/SUP], Shengzhong Li[SUP] 4 [/SUP], Xuefeng Yu[SUP] 1 [/SUP], Chen Dong[SUP] 5 [/SUP], Benping Zhang[SUP] 1 [/SUP]
Affiliations
- PMID: 33035409
- DOI: 10.1111/jdi.13431
Abstract
Aim: This study aimed to explore the association between glycemic control prior to admission with severity and mortality of COVID-19, and tried to reveal the mechanism.
Methods: 77 inpatients were grouped into sufficient control group (HbA1c<6.5%, n=49) and insufficient control group (HbA1c ≥ 6.5%, n=28). Regression models were used to analyze the clinical data.
Results: Compared with patients with HbA1C < 6.5, patients with HbA1C ≥ 6.5 showed higher heart rate (101 vs. 89 beats per min, P=0.012), lower percutaneous oxygen saturation (93% vs. 97%, P=0.001), higher levels of multiple indicators of inflammation, such as white blood cell count (7.9 vs. 5.9 ?10⁹/L, P=0.019), neutrophil count (6.5 vs. 4.1 ?10⁹/L, P=0.001), high-sensitivity C-reactive protein (52 vs. 30 mg/L, P=0.025), and serum ferritin (1287 vs. 716 μg/L, P=0.023), as well as lower level of lymphocyte count (0.7 vs. 0.8 ?10⁹/L P=0.049) at hospital admission. Thus, patients with HbA1C ≥ 6.5 were more likely to develop secondary respiratory infections (25 [89%] vs. 33 [67%], P=0.032) and acute respiratory distress syndrome (ARDS) (17 [61%] vs. 14 [29%], P=0.006) than patients with HbA1C < 6.5, resulting in a higher proportion of critically ill cases (19 [68%] vs. 18 [37%], P=0.009) and non-survivors (13 [46%] vs. 11 [22%], P=0.029). After adjustment for potential risk factors, HbA1C was independently associated with in-hospital death.
Conclusion: HbA1c was an independent risk factor for poor outcomes in COVID-19 patients. Severe pulmonary infection and consequent ARDS might be the primary causes of death in insufficient glycemic control patients.
Keywords: Coronavirus Disease 2019; glycemic control; prognosis.