High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis. (January 2021)

• Record Type: Journal Article
• Authors: Lazarus, Gilbert; Audrey, Jessica; Wangsaputra, Vincent Kharisma; Tamara, Alice; Tahapary, Dicky L.
• Is Part Of: Diabetes research and clinical practice. Volume 171(2021)
• Publication Date: 2021-01
• Subjects: Blood glucose -- COVID-19 -- Fasting -- Patient admission -- Prognosis; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108561
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Admission fasting blood glucose (AFBG) independently predicts poor COVID-19 outcomes. Risk of COVID-19 severity rises by 33% for each 1 mmol/L increase in AFBG. There is high-quality evidence on the independent link between AFBG and severity. We found moderate-quality evidence linking AFBG with mortality and poor outcomes. Further researches on the independent prognostic value of admission random BG are required. Abstract: Aims: To investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. Methods: Eligible studies evaluating the association between admission fasting BG (FBG) and random BG (RBG) levels with COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects dose-response meta-analysis was conducted to investigate potential linear or non-linear exposure-response gradient. Results: The search yielded 35 studies involving a total of 14, 502 patients. We discovered independent association between admission FBG and poor COVID-19 prognosis. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity < 0.001), where each 1 mmol/L increase augmented the risk of severity by 33% (risk ratio 1.33 [95% CI: 1.26–1.40]). Albeit exhibiting similar trends, study scarcity limited the evidence strength on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes. Conclusion: High admission FBG level independently predicted poor COVID-19 prognosis. Further research to confirm the prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and COVID-19 severity are required.