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Hyperglycemia in Severe and Critical COVID-19 Patients: Risk Factors and Outcomes

Viet Tran Le1, Quoc Hung Ha1, Minh Triet Tran2

  • 1COVID-19 Intensive Care Center, University Medical Center, Ho Chi Minh City, VNM.

Cureus
|August 11, 2022
PubMed

Insights

Hyperglycemia is common in critically ill COVID-19 patients, affecting 65.6%. New-onset hyperglycemia significantly increases mortality risk compared to diabetes-related hyperglycemia.

Area of Science:

  • Critical care medicine
  • Endocrinology
  • Infectious diseases

Background:

  • Hyperglycemia is a frequent complication in critically ill patients, including those with coronavirus disease 2019 (COVID-19).
  • Elevated blood glucose levels in COVID-19 patients are associated with poorer prognosis and increased mortality.
  • Understanding the prevalence, risk factors, and outcomes of hyperglycemia in COVID-19 is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence of hyperglycemia in intensive care unit (ICU) patients with COVID-19.
  • To identify risk factors associated with hyperglycemia in both diabetic and non-diabetic COVID-19 patients.
  • To evaluate the prognostic implications of hyperglycemia, particularly new-onset hyperglycemia, on mortality.

Main Methods:

  • A retrospective observational study was conducted on COVID-19 patients admitted to an ICU.
  • Patients were categorized into non-hyperglycemia, hyperglycemia in diabetic patients, and new-onset hyperglycemia groups.
  • Multinomial logistic and multivariable Cox regression models were used to analyze risk factors and mortality.

Main Results:

  • Hyperglycemia was observed in 65.6% of patients, with 44.8% being diabetic and 20.8% having new-onset hyperglycemia.
  • In-hospital and 28-day mortality rates were 30.2% and 26.1%, respectively.
  • New-onset hyperglycemia showed the highest risk for 28-day mortality (HR 3.535) compared to hyperglycemia in diabetic patients (HR 1.408).

Conclusions:

  • Hyperglycemia is prevalent in critically ill COVID-19 patients and can indicate disease severity or result from treatment.
  • New-onset hyperglycemia in COVID-19 patients is linked to significantly worse outcomes than hyperglycemia in pre-existing diabetes.
  • Identifying and managing hyperglycemia, especially new-onset cases, is vital for improving survival rates in COVID-19 patients.
Abstract

Keywords:
corticosteroidcovid-19diabeteshyperglycemiaintensive care

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