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Does inpatient hyperglycemia predict a worse outcome in COVID-19 intensive care unit patients?

Aisha R Saand1, Monica Flores1, Tariq Kewan1

  • 1Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, Ohio, USA.

Journal of Diabetes
|November 20, 2020
PubMed

Insights

Hyperglycemia in COVID-19 patients admitted to the ICU is linked to worse outcomes, including higher mortality and increased need for mechanical ventilation. Tighter blood glucose control may improve results for critically ill patients.

Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Infectious Diseases

Background:

  • The association between hyperglycemia and outcomes in critically ill patients with coronavirus disease 2019 (COVID-19) requires further investigation.
  • Understanding this relationship is crucial for managing severe COVID-19 cases.

Purpose of the Study:

  • To evaluate the association between hyperglycemia and outcomes in intensive care unit (ICU) patients with COVID-19.
  • To identify predictors of hyperglycemia in this patient population.

Main Methods:

  • A multicenter retrospective study included adults with COVID-19 admitted to the ICU from March to May 2020.
  • Patients were categorized into normoglycemic (<140 mg/dL) and hyperglycemic (≥140 mg/dL) groups based on average blood glucose.
  • Outcomes measured included mortality, mechanical ventilation requirements and duration, and length of hospital and ICU stays.

Main Results:

  • Hyperglycemic patients had significantly higher mortality (31.4% vs 16.6%) and mechanical ventilation rates (50.0% vs 37.2%) compared to normoglycemic patients.
  • Hyperglycemia and age over 60 were significant predictors of in-hospital mortality (HR 1.79 and 3.21, respectively).
  • Factors associated with increased risk of hyperglycemia included steroid use, elevated triglycerides, and African American race.

Conclusions:

  • Hyperglycemia in COVID-19 ICU patients is associated with prolonged ICU stay, increased mechanical ventilation need, and higher mortality risk.
  • Tighter blood glucose control (≤140 mg/dL) may improve outcomes for critically ill COVID-19 patients.
  • Further evidence from clinical trials is needed to confirm the benefits of tighter glucose control.
Abstract

Keywords:
COVID-19critical care unitglucose controlhyperglycemiamortality死亡率血糖控制重症监护病房高血糖

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