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Hyperglycaemia increases mortality risk in non-diabetic patients with COVID-19 even more than in diabetic patients

Jennifer Morse1, Wendy Gay1, Kimberly M Korwek1

  • 1Clinical Operations Group, HCA Healthcare, Nashville, TN, USA.

Endocrinology, Diabetes & Metabolism
|September 10, 2021
PubMed

Insights

Hyperglycaemia, or high blood sugar, is a significant risk factor for COVID-19 mortality, even in patients without diabetes. Effective glucose control in hospitalized COVID-19 patients may reduce mortality risk.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Diabetes mellitus is a known risk factor for severe COVID-19 outcomes.
  • The role of hyperglycemia (high blood glucose) in COVID-19 mortality, irrespective of diabetes status, requires further investigation.

Purpose of the Study:

  • To examine the association between hyperglycemia and COVID-19 severity and mortality.
  • To determine if hyperglycemia independently predicts mortality in hospitalized COVID-19 patients, with or without a pre-existing diabetes diagnosis.

Main Methods:

  • Retrospective analysis of 74,148 COVID-19 inpatients with recorded glucose measurements.
  • Categorization based on pre-existing diabetes diagnosis and presence of hyperglycemic glucose values (>180 mg/dl).
  • Statistical adjustment for age, BMI, admission severity, and oxygen saturation.

Main Results:

  • Hyperglycemia was associated with substantially higher mortality rates in both diabetic (14.4%) and non-diabetic (21.7%) patients compared to those with normal glucose levels.
  • After adjusting for confounders, hyperglycemia remained an independent predictor of mortality.
  • The odds of mortality were significantly increased by hyperglycemia in both groups (OR 1.77 for diabetics, OR 3.07 for non-diabetics).

Conclusions:

  • Hyperglycemia is an independent risk factor for mortality in hospitalized COVID-19 patients.
  • Glucose control may be a modifiable factor to reduce COVID-19 mortality.
  • These findings highlight the importance of monitoring and managing blood glucose levels in all COVID-19 patients.
Abstract

Keywords:
COVID-19glucose variabilityhyperglycaemiainpatient glycaemic management

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