Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study. (May 2022)

• Record Type: Journal Article
• Authors: Clausen, Clara L.; Leo-Hansen, Christian; Faurholt-Jepsen, Daniel; Krogh-Madsen, Rikke; Ritz, Christian; Kirk, Ole; Jørgensen, Henrik L.; Benfield, Thomas; Almdal, Thomas P.; Snorgaard, Ole
• Is Part Of: Diabetes research and clinical practice. Volume 187(2022)
• Publication Date: 2022-05
• Subjects: COVID-19 -- Glucometabolic changes -- Glycemic gap -- Mortality -- Hospitalization; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.109880
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality. Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA1c measurement 60 days prior to or within 7 days after admission. We studied the association between diabetes status, the glycemic gap (difference between admission and habitual status), admission plasma-glucose, and mortality using Cox proportional hazards regression. Results: Of 674 patients included, 114 (17%) had normal glucose level, 287 (43%) had pre-diabetes, 74 (11%) had new-onset, and 199 (30%) had diagnosed diabetes. No association between diabetes status, plasma-glucose at admission, and mortality was found. Compared to the 2nd quartile (reference) of glycemic-gap, those with the highest glycemic gap had increased mortality (3rd (HR 2.38 [1.29–4.38], p = 0.005) and 4th quartile (HR 2.48 [1.37–4.52], p = 0.002 ). Conclusion: Abnormal glucose metabolism was highly prevalent among patients hospitalized with COVID-19. Diabetes status per se or admission plasma-glucose was not associated with a poorer outcome. However, a high glycemic gap was associated with increased risk of mortality, suggesting that, irrespective of diabetes status, glycemic stress serves as an important prognostic marker for mortality.