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Association between Hb A1c and Severity of COVID-19 Patients

Goksenin Unluguzel Ustun1, Adem Keskin2, Recai Aci1

  • 1Department of Biochemistry, University of Health Sciences, Samsun, Turkey.

Hemoglobin
|June 24, 2021
PubMed

Insights

High hemoglobin A1c (HbA1c) levels in COVID-19 patients are linked to increased inflammation, coagulation issues, and higher mortality rates. Monitoring HbA1c may improve risk assessment for severe COVID-19 outcomes.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Diabetes, indicated by elevated hemoglobin A1c (HbA1c), is a known risk factor for severe infections.
  • The clinical implications of varying HbA1c levels in coronavirus-19 (COVID-19) patients require further investigation.
  • Understanding these associations can aid in predicting COVID-19 severity and patient outcomes.

Purpose of the Study:

  • To investigate the relationship between HbA1c levels and the clinical course of COVID-19.
  • To assess the impact of high HbA1c on intensive care unit (ICU) admission and mortality in COVID-19 patients.
  • To identify correlations between HbA1c levels and key inflammatory and coagulation markers.

Main Methods:

  • Retrospective analysis of 66 COVID-19 positive (COVID-19(+)) patients with high HbA1c, 46 COVID-19(+) patients with average HbA1c, and 30 COVID-19 negative patients.
  • Comparison of clinical parameters including hemoglobin (Hb), oxygen saturation (SaO2), ferritin, D-dimer, procalcitonin (PCT), C-reactive protein (CRP), and lactate dehydrogenase (LDH) between groups.
  • Correlation analysis between HbA1c levels and clinical parameters; Chi-squared test used for ICU admission and mortality analysis.

Main Results:

  • COVID-19(+) groups exhibited lower Hb and SaO2, and higher ferritin, D-dimer, PCT, and CRP compared to controls.
  • High HbA1c COVID-19(+) patients showed elevated LDH, PCT, and D-dimer, with lower Hb and partial arterial oxygen pressure (PaO2).
  • HbA1c positively correlated with absolute neutrophil count (ANC), LDH, PCT, and potassium (K+); negatively correlated with Hb and PaO2. High HbA1c was associated with increased mortality.

Conclusions:

  • Elevated HbA1c levels in COVID-19 patients are significantly associated with heightened inflammation, coagulation disturbances, and hypoxemia.
  • High HbA1c is a predictor of increased mortality risk in COVID-19 patients.
  • Integrating HbA1c measurements with other prognostic markers can enhance the assessment of mortality risk in COVID-19.

Keywords:
Coronavirus-19 (COVID-19)Hb A1cdiabetes mellitus (DM)mortality

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