Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study

Aims/hypothesis Hyperglycaemia is associated with an elevated risk of mortality in community-acquired pneumonia, stroke, acute myocardial infarction, trauma and surgery, among other conditions. In this study, we examined the relationship between fasting blood glucose (FBG) and 28-day mortality in co...

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Published in:Diabetologia Vol. 63; no. 10; pp. 2102 - 2111
Main Authors: Wang, Sufei, Ma, Pei, Zhang, Shujing, Song, Siwei, Wang, Zhihui, Ma, Yanling, Xu, Juanjuan, Wu, Feng, Duan, Limin, Yin, Zhengrong, Luo, Huilin, Xiong, Nian, Xu, Man, Zeng, Tianshu, Jin, Yang
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2020
Springer Nature B.V
Subjects:
Adult
Aged
Betacoronavirus - isolation & purification
Betacoronavirus - pathogenicity
Biomarkers - blood
Blood Glucose - metabolism
Blood pressure
Cerebral infarction
China - epidemiology
Clinical Laboratory Techniques
Coronavirus Infections - blood
Coronavirus Infections - diagnosis
Coronavirus Infections - mortality
Coronavirus Infections - virology
Coronaviruses
COVID-19
COVID-19 Testing
Diabetes
Diabetes mellitus
Diagnosis
Fasting
Fasting - blood
Female
Glucose
Hospital Mortality
Hospitals
Host Microbial Interactions
Human Physiology
Humans
Hyperglycemia
Internal Medicine
Laboratory testing
Male
Medical diagnosis
Medicine
Medicine & Public Health
Metabolic Diseases
Metabolic disorders
Middle Aged
Mortality
Myocardial infarction
Pandemics
Patient Admission
Patients
Pneumonia
Pneumonia, Viral - blood
Pneumonia, Viral - diagnosis
Pneumonia, Viral - mortality
Pneumonia, Viral - virology
Predictive Value of Tests
Prognosis
Respiration
Retrospective Studies
Risk Assessment
Risk Factors
SARS-CoV-2
Surgery
Time Factors
Trauma
China
Coronavirus disease 2019
Mortality
Fasting blood glucose
ISSN:0012-186X, 1432-0428, 1432-0428
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Summary:Aims/hypothesis Hyperglycaemia is associated with an elevated risk of mortality in community-acquired pneumonia, stroke, acute myocardial infarction, trauma and surgery, among other conditions. In this study, we examined the relationship between fasting blood glucose (FBG) and 28-day mortality in coronavirus disease 2019 (COVID-19) patients not previously diagnosed as having diabetes. Methods We conducted a retrospective study involving all consecutive COVID-19 patients with a definitive 28-day outcome and FBG measurement at admission from 24 January 2020 to 10 February 2020 in two hospitals based in Wuhan, China. Demographic and clinical data, 28-day outcomes, in-hospital complications and CRB-65 scores of COVID-19 patients in the two hospitals were analysed. CRB-65 is an effective measure for assessing the severity of pneumonia and is based on four indicators, i.e. confusion, respiratory rate (>30/min), systolic blood pressure (≤90 mmHg) or diastolic blood pressure (≤60 mmHg), and age (≥65 years). Results Six hundred and five COVID-19 patients were enrolled, including 114 who died in hospital. Multivariable Cox regression analysis showed that age (HR 1.02 [95% CI 1.00, 1.04]), male sex (HR 1.75 [95% CI 1.17, 2.60]), CRB-65 score 1–2 (HR 2.68 [95% CI 1.56, 4.59]), CRB-65 score 3–4 (HR 5.25 [95% CI 2.05, 13.43]) and FBG ≥7.0 mmol/l (HR 2.30 [95% CI 1.49, 3.55]) were independent predictors for 28-day mortality. The OR for 28-day in-hospital complications in those with FBG ≥7.0 mmol/l and 6.1–6.9 mmol/l vs <6.1 mmol/l was 3.99 (95% CI 2.71, 5.88) or 2.61 (95% CI 1.64, 4.41), respectively. Conclusions/interpretation FBG ≥7.0 mmol/l at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes. Glycaemic testing and control are important to all COVID-19 patients even where they have no pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders. Graphical abstract
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ISSN:0012-186X
1432-0428
1432-0428
DOI:10.1007/s00125-020-05209-1