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Association between inpatient glycemic variability and COVID-19 mortality: a prospective study

Salma Ali El Chab Parolin1, Rebecca Benicio Stocco2, Julia do Carmo Kneipp Lopes2

  • 1Pontifical Catholic University of Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil. salmacp@yahoo.com.br.

Diabetology & Metabolic Syndrome
|September 12, 2023
PubMed

Insights

High glycemic variability, a measure of blood sugar fluctuations, significantly increased mortality risk in hospitalized COVID-19 patients. This association held true for individuals with and without diabetes mellitus, highlighting its importance in critical care.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Hospitalized patients with coronavirus disease 2019 (COVID-19) face significant mortality risks.
  • Glycemic variability (GV) is increasingly recognized as a critical factor in patient outcomes.
  • The specific association between GV and mortality in COVID-19 patients requires further elucidation.

Purpose of the Study:

  • To investigate the relationship between glycemic variability (GV) and mortality in hospitalized COVID-19 patients.
  • To determine if GV is an independent predictor of mortality, irrespective of diabetes status.
  • To establish cutoff values for GV that indicate increased mortality risk.

Main Methods:

  • Prospective analysis of 628 inpatients (age >18) with confirmed COVID-19.
  • Measurement of GV using standard deviation (SD) and coefficient of variation (CV) from capillary glucose tests.
  • Logistic regression models adjusted for age, sex, diabetes mellitus, and cardiovascular disease to assess mortality association.

Main Results:

  • High GV, defined as SD ≥ 44.7 mg/dL or CV ≥ 27.5%, was significantly associated with increased mortality.
  • Patients with high GV had higher mortality rates compared to those with low GV (OR 2.99 for SD, 2.43 for CV; p<0.001).
  • This association remained significant regardless of the presence of diabetes mellitus.

Conclusions:

  • Elevated glycemic variability is an independent risk factor for mortality in COVID-19 patients.
  • Monitoring and managing GV may be crucial for improving outcomes in hospitalized COVID-19 patients.
  • The findings underscore the importance of glycemic control beyond average glucose levels in critical illness.
Abstract

Keywords:
COVID-19Glycemic variabilityMortality, inpatient

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