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Thromboembolism risk among patients with diabetes/stress hyperglycemia and COVID-19

Stefania L Calvisi1, Giuseppe A Ramirez2, Marina Scavini3

  • 1Unit of General Medicine and Advanced Care, IRCCS Ospedale San Raffaele, Milan, Italy.

Metabolism: Clinical and Experimental
|August 8, 2021
PubMed

Insights

Patients with diabetes or stress hyperglycemia face higher risks of blood clots and poor outcomes from COVID-19 pneumonia. These individuals may benefit from enhanced prophylactic anticoagulation strategies.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Endocrinology

Background:

  • Diabetes and stress hyperglycemia are known risk factors for adverse outcomes in patients with SARS-CoV-2 infection.
  • The role of thromboembolic complications in this increased risk remains to be fully elucidated.

Purpose of the Study:

  • To investigate whether an increased risk of thromboembolic complications modulates the adverse clinical outcome in patients with diabetes/stress hyperglycemia and COVID-19 pneumonia.
  • To analyze the association between diabetes/stress hyperglycemia and thromboembolic events in hospitalized COVID-19 patients.

Main Methods:

  • Prospective follow-up of 169 hospitalized patients with confirmed COVID-19 pneumonia.
  • Analysis of inflammation, tissue damage biomarkers, hemostatic parameters, thrombotic events (TEs), and clinical outcomes.
  • Stratification of patients based on the presence of diabetes/stress hyperglycemia and fasting blood glucose levels.

Main Results:

  • Diabetes/stress hyperglycemia was associated with increased inflammation, tissue damage markers, higher D-dimer, prolonged prothrombin time, and lower antithrombin III activity.
  • Diabetes/stress hyperglycemia, fasting blood glucose, and glucose variability significantly increased the risk of thromboembolic complications.
  • Thromboembolic events heightened the risk of adverse clinical outcomes specifically in patients with diabetes/stress hyperglycemia or elevated fasting blood glucose.

Conclusions:

  • Thromboembolism risk is elevated in COVID-19 pneumonia patients with diabetes/stress hyperglycemia, contributing to poor clinical outcomes.
  • Consideration for more intensive prophylactic anticoagulation is warranted for SARS-CoV-2 infected patients with diabetes/stress hyperglycemia.
Abstract

Keywords:
COVID-19Clinical outcomeDiabetesHumoral responseSARS-CoV-2Thromboembolism

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