[HEMOGLOBIN A1C AND MORTALITY FROM COVID-19].
Eugene Merzon1,2, Ilan Green1, Miriam Shpigelman3
1Leumit HMO, Medical Division, Tel-Aviv, Israel.
Harefuah
|October 24, 2021
Summary
Poor glycemic control, indicated by high HbA1c levels before coronavirus disease 2019 (COVID-19) infection, significantly increases mortality risk in diabetic patients. Pre-existing cerebrovascular disease also elevates risk, while adequate vitamin D and iron levels offer protection.
Area of Science:
- Endocrinology
- Infectious Diseases
- Public Health
Background:
- Diabetes mellitus increases COVID-19 severity and mortality risk.
- Pre-infection glycemic control's impact on COVID-19 outcomes remains unclear.
- Previous research linked HbA1c > 9% to hospitalization in diabetic COVID-19 patients.
Purpose of the Study:
- To examine clinical characteristics of diabetic patients who died from COVID-19.
- To determine the association between pre-infection glycemic control and COVID-19 mortality.
- To identify predictors of COVID-19 mortality in diabetic and pre-diabetic individuals.
Main Methods:
- Retrospective collection of demographic, clinical, and laboratory data for COVID-19 patients with diabetes/pre-diabetes.
- Case-control study (1:5 ratio) comparing deceased patients with survivors, adjusting for confounders.
- Multivariate logistic regression analysis to identify risk and protective factors.
Main Results:
- 2.7% of 888 identified patients died from COVID-19.
- Deceased patients were older, had more comorbidities, higher HbA1c, and lower vitamin D and iron levels.
- High HbA1c and cerebrovascular disease increased mortality risk; normal vitamin D, iron, and eGFR > 60ml/min were protective.
Conclusions:
- Pre-infection HbA1c levels and cerebrovascular disease are significant predictors of COVID-19 mortality.
- Identifying these pre-infection parameters aids in risk stratification and prioritizing at-risk populations.
- Further research is required to elucidate the mechanisms linking poor glycemic control to COVID-19 mortality.
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