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Association of Early-Phase In-Hospital Glycemic Fluctuation With Mortality in Adult Patients With Coronavirus Disease

Liangkai Chen1, Wenwu Sun2, Yanli Liu2

  • 1Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Diabetes Care
|January 22, 2021
PubMed

Insights

Poor early glycemic control in hospitalized coronavirus disease 2019 (COVID-19) patients is linked to worse outcomes. Higher glucose levels and fluctuations during the first week increased risks of acute respiratory distress syndrome and death.

Area of Science:

  • Internal Medicine
  • Endocrinology
  • Infectious Diseases

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis.
  • Glycemic control is crucial for managing critically ill patients, but its impact on COVID-19 outcomes is not fully understood.

Purpose of the Study:

  • To investigate the association between early-phase in-hospital glycemic control and adverse outcomes in COVID-19 patients.
  • To determine if glycemic status and fluctuation in the first week of hospitalization impact severe pneumonia, acute respiratory distress syndrome (ARDS), and mortality.

Main Methods:

  • A large case series of 548 hospitalized COVID-19 patients in Wuhan, China.
  • Collected daily fasting glucose data during the first week of hospitalization.
  • Analyzed glycemic status (mean glucose) and fluctuation (variance of glucose levels) in relation to clinical outcomes.

Main Results:

  • Patients with higher mean glucose levels in the first week had increased risks of severe pneumonia, ARDS, and death.
  • Elevated glycemic fluctuation was associated with a nearly twofold increased risk of ARDS (RR 1.97) and a 2.7-fold increased risk of mortality.
  • Older age, comorbidities, and abnormal laboratory markers were associated with higher glucose levels.

Conclusions:

  • Early-phase glycemic control is a significant factor in COVID-19 patient outcomes.
  • Optimizing glycemic control strategies during the early hospitalization phase may improve clinical outcomes for COVID-19 patients.
Abstract

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