Abstract
Aims
We aimed to investigate the role of Fasting Plasma Glucose (FPG) and glucose fluctuation in the prognosis of COVID-19 patients stratified by pre-existing diabetes.
Methods
The associations of FPG and glucose fluctuation indexes with prognosis of COVID-19 in 2,642 patients were investigated by multivariate Cox regression analysis. The primary outcome was in-hospital mortality; the secondary outcome was disease progression. The longitudinal changes of FPG over time were analyzed by the latent growth curve model in COVID-19 patients stratified by diabetes and severity of COVID-19.
Results
We found FPG as an independent prognostic factor of overall survival after adjustment for age, sex, diabetes and severity of COVID-19 at admission (HR: 1.15, 95% CI: 1.06–1.25, P = 1.02 × 10−3). Multivariate logistic regression analysis indicated that the standard deviation of blood glucose (SDBG) and largest amplitude of glycemic excursions (LAGE) were also independent risk factors of COVID-19 progression (P = 0.03 and 0.04, respectively). The growth trajectory of FPG over the first 3 days of hospitalization was steeper in patients with critical COVID-19 in comparison to moderate patients.
Conclusions
Hyperglycemia and glucose fluctuation were adverse prognostic factors of COVID-19 regardless of pre-existing diabetes. This stresses the importance of glycemic control in addition to other therapeutic management.
【저자키워드】 COVID-19, coronavirus, diabetes, Fasting plasma glucose, Blood glucose fluctuation, 【초록키워드】 Prognosis, Hospitalization, Sex, Disease progression, survival, severity of COVID-19, management, therapeutic, Patient, age, Admission, Critical, moderate, patients, glycemic control, Glucose, association, Analysis, blood glucose, COVID-19 patient, Prognostic factor, Growth Curve, In-hospital, COVID-19 progression, Standard deviation, Logistic regression analysis, Primary outcome, multivariate Cox regression, multivariate, secondary outcome, independent risk factor, amplitude, fasting, independent, longitudinal change, fluctuation, Result, analyzed, indicated, addition, investigated, diabete, stratified, glycemic, growth trajectory, 【제목키워드】 Prognosis, plasma, Glucose, fasting, fluctuation, diabete, with COVID-19,