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Association of Elevated Glycated Hemoglobin (HbA1c) in COVID-19 Patients Admitted to the Intensive Care Unit and

Adan M Cuevas Velazquez1, Wern Lynn Ng1, Evelyn J Calderon Martinez1

  • 1Internal Medicine, University of Pittsburgh Medical Center, Harrisburg, USA.

Cureus
|June 29, 2023
PubMed

Insights

Elevated glycated hemoglobin (HbA1c) levels in COVID-19 patients did not correlate with increased in-hospital mortality. However, higher HbA1c was linked to a greater need for insulin drip in ICU patients.

Area of Science:

  • Critical Care Medicine
  • Endocrinology
  • Infectious Diseases

Background:

  • Diabetes is a significant comorbidity in COVID-19 patients.
  • Glycemic control, indicated by HbA1c, may influence COVID-19 outcomes.
  • Understanding this association is crucial for managing diabetic patients with COVID-19.

Purpose of the Study:

  • To investigate the association between elevated glycated hemoglobin (HbA1c) levels and clinical outcomes in COVID-19 patients admitted to the ICU.
  • To assess the relationship between HbA1c levels and in-hospital mortality, 90-day mortality, insulin drip requirement, and length of stay.

Main Methods:

  • Observational retrospective study using electronic health records from UPMC Central PA Hospitals.
  • Analysis of 384 diabetic COVID-19 patients admitted to the ICU between May 2021 and May 2022.
  • Stratification of patients based on HbA1c levels ( <7%, 7-9%, >9%) obtained within three months prior to admission.

Main Results:

  • Mortality rates were 54.1% (HbA1c<7%), 65.49% (HbA1c 7-9%), and 43.18% (HbA1c>9%).
  • No linear association was found between higher HbA1c and increased in-hospital mortality.
  • 90-day mortality rates did not significantly differ across HbA1c groups, but insulin drip need increased with higher HbA1c.

Conclusions:

  • Higher HbA1c levels in diabetic COVID-19 ICU patients were not associated with increased in-hospital or 90-day mortality.
  • Increased need for insulin drip was observed in patients with higher HbA1c levels.
  • BMI did not show significant differences across HbA1c groups, with most patients classified as low-risk.

Keywords:
a1ccovid-19diabetes mellitushyperglycemiaoutcome measure

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