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Glycemic control before admission is an important determinant of prognosis in patients with coronavirus disease 2019

Li Liu1, Wang Wei2, Kun Yang3

  • 1Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Journal of Diabetes Investigation
|October 9, 2020
PubMed

Insights

Poor glycemic control, indicated by high hemoglobin A1c (HbA1c), is linked to severe COVID-19 outcomes. Elevated HbA1c levels predict increased mortality risk in coronavirus disease 2019 patients.

Area of Science:

  • • Medical Research
  • • Clinical Medicine
  • • Infectious Diseases

Background:

  • • Coronavirus disease 2019 (COVID-19) poses significant global health challenges.
  • • Glycemic control is a critical factor in managing chronic conditions and can impact acute illness severity.
  • • Understanding the relationship between pre-admission glycemic status and COVID-19 outcomes is crucial for patient management.

Purpose of the Study:

  • • To investigate the association between pre-admission glycemic control and the severity of COVID-19.
  • • To explore the link between glycemic control and mortality in COVID-19 patients.
  • • To elucidate potential mechanisms underlying this association.

Main Methods:

  • • A cohort of 77 COVID-19 inpatients was analyzed.
  • • Patients were categorized into two groups based on glycated hemoglobin (HbA1c) levels: sufficient control (HbA1c <6.5%) and insufficient control (HbA1c ≥6.5%).
  • • Clinical data were analyzed using regression models to determine associations.

Main Results:

  • • Patients with insufficient glycemic control (HbA1c ≥6.5%) exhibited significantly higher heart rates and lower oxygen saturation upon admission.
  • • Higher inflammatory markers (white blood cell count, neutrophil count, C-reactive protein, ferritin) and lower lymphocyte counts were observed in the insufficient control group.
  • • Insufficient glycemic control was associated with increased rates of secondary respiratory infections, acute respiratory distress syndrome (ARDS), critical illness, and in-hospital death.

Conclusions:

  • • Pre-admission glycated hemoglobin (HbA1c) is an independent risk factor for adverse outcomes in COVID-19 patients.
  • • Poor glycemic control may lead to severe pulmonary infections and subsequent ARDS, contributing to mortality.
  • • Maintaining adequate glycemic control is vital for improving prognosis in patients with COVID-19.
Abstract

Keywords:
Coronavirus disease 2019Glycemic controlPrognosis

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