tetano
Editor, Senior Moderator
Pathogens
. 2022 Aug 10;11(8):902.
doi: 10.3390/pathogens11080902.
Elevated Fasting Blood Glucose Levels Are Associated with Worse Clinical Outcomes in COVID-19 Patients Than in Pneumonia Patients with Bacterial Infections
Wenjun Wang[SUP] 1 2 3 [/SUP], Zhonglin Chai[SUP] 4 [/SUP], Mark E Cooper[SUP] 4 [/SUP], Paul Z Zimmet[SUP] 4 [/SUP], Hua Guo[SUP] 5 [/SUP], Junyu Ding[SUP] 5 [/SUP], Feifei Yang[SUP] 1 2 3 [/SUP], Xixiang Lin[SUP] 1 2 3 [/SUP], Xu Chen[SUP] 1 2 3 [/SUP], Xiao Wang[SUP] 1 2 3 [/SUP], Qin Zhong[SUP] 1 2 3 [/SUP], Zongren Li[SUP] 1 2 3 [/SUP], Peifang Zhang[SUP] 6 [/SUP], Zhenzhou Wu[SUP] 6 [/SUP], Xizhou Guan[SUP] 5 [/SUP], Lei Zhang[SUP] 4 7 8 9 [/SUP], Kunlun He[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Aims: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections.
Methods: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity.
Results: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80-37.96), 5.72 (2.95-11.06), 2.60 (1.20-5.32), 1.42 (1.26-1.59), and 5.16 (3.26-8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21-6.29]; 1.56 [1.17-2.07]; 0.98 [0.88-1.11]; 2.06 [1.26-3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36-6.41]; 2.31 [1.76-3.05]; 1.21 [0.97-1.52]; 1.02 [0.93-1.13]; 1.72 [1.19-2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher.
Conclusions: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
Keywords: COVID-19; clinical severities; fasting blood glucose; pneumonia patients.
. 2022 Aug 10;11(8):902.
doi: 10.3390/pathogens11080902.
Elevated Fasting Blood Glucose Levels Are Associated with Worse Clinical Outcomes in COVID-19 Patients Than in Pneumonia Patients with Bacterial Infections
Wenjun Wang[SUP] 1 2 3 [/SUP], Zhonglin Chai[SUP] 4 [/SUP], Mark E Cooper[SUP] 4 [/SUP], Paul Z Zimmet[SUP] 4 [/SUP], Hua Guo[SUP] 5 [/SUP], Junyu Ding[SUP] 5 [/SUP], Feifei Yang[SUP] 1 2 3 [/SUP], Xixiang Lin[SUP] 1 2 3 [/SUP], Xu Chen[SUP] 1 2 3 [/SUP], Xiao Wang[SUP] 1 2 3 [/SUP], Qin Zhong[SUP] 1 2 3 [/SUP], Zongren Li[SUP] 1 2 3 [/SUP], Peifang Zhang[SUP] 6 [/SUP], Zhenzhou Wu[SUP] 6 [/SUP], Xizhou Guan[SUP] 5 [/SUP], Lei Zhang[SUP] 4 7 8 9 [/SUP], Kunlun He[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 36015023
- DOI: 10.3390/pathogens11080902
Abstract
Aims: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections.
Methods: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity.
Results: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80-37.96), 5.72 (2.95-11.06), 2.60 (1.20-5.32), 1.42 (1.26-1.59), and 5.16 (3.26-8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21-6.29]; 1.56 [1.17-2.07]; 0.98 [0.88-1.11]; 2.06 [1.26-3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36-6.41]; 2.31 [1.76-3.05]; 1.21 [0.97-1.52]; 1.02 [0.93-1.13]; 1.72 [1.19-2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher.
Conclusions: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
Keywords: COVID-19; clinical severities; fasting blood glucose; pneumonia patients.