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 HbA 1c 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.
Keywords: COVID-19; Glucometabolic changes; Glycemic gap; Hospitalization; Mortality.
【저자키워드】 COVID-19, Mortality, Hospitalization, mortality., Glucometabolic changes, Glycemic gap, 【초록키워드】 Stress, diabetes, outcome, metabolism, Prevalence, Patient, Prognostic marker, Admission, Glucose, association, Pre-diabetes, increased risk, increased mortality, quartile, prevalent, highest, diagnosed, diabete, All participant, Cox proportional hazard, glycemic, patients hospitalized, with COVID-19, 【제목키워드】 outcome, Patient, change, Observational cohort study,