TY - JOUR

T1 - Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study

AU - Clausen, Clara L.

AU - Leo-Hansen, Christian

AU - Faurholt-Jepsen, Daniel

AU - Krogh-Madsen, Rikke

AU - Ritz, Christian

AU - Kirk, Ole

AU - Jørgensen, Henrik L.

AU - Benfield, Thomas

AU - Almdal, Thomas P.

AU - Snorgaard, Ole

N1 - Publisher Copyright: © 2022

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - COVID-19

KW - Glucometabolic changes

KW - Glycemic gap

KW - Hospitalization

KW - Mortality

U2 - 10.1016/j.diabres.2022.109880

DO - 10.1016/j.diabres.2022.109880

M3 - Journal article

C2 - 35483546

AN - SCOPUS:85129523626

VL - 187

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

M1 - 109880

ER -