Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19
BackgroundInflammation is a predictor of severe complications in patients with COVID-19 infection under a variety of clinical settings. A few studies suggested that COVID-19 infection was a trigger of hyperglycemic crises including diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-02-01
|
| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1287795/full |
| _version_ | 1797300072129495040 |
|---|---|
| author | Li-Chan Tao Hong Shu Ying Wang Qian Hou Jian-Jun Li Xiao-Lin Huang Fei Hua |
| author_facet | Li-Chan Tao Hong Shu Ying Wang Qian Hou Jian-Jun Li Xiao-Lin Huang Fei Hua |
| author_sort | Li-Chan Tao |
| collection | DOAJ |
| description | BackgroundInflammation is a predictor of severe complications in patients with COVID-19 infection under a variety of clinical settings. A few studies suggested that COVID-19 infection was a trigger of hyperglycemic crises including diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS). However, the association between inflammation and hyperglycemic crises in diabetic patients with COVID-19 infection is unclear.MethodsOne hundred and twenty-four patients with type 2 diabetes mellitus (T2DM) and COVID-19 infection from January 2023 to March 2023 were retrospectively analyzed. Demographic, clinical, and laboratory data, especially inflammatory markers including white blood cell (WBC), neutrophils, neutrophil-to-lymphocyte ratio (NLR), c-reactive protein (CRP) and procalcitonin (PCT) were collected and compared between patients with or without DKA and/or HHS. Multivariable logistic regression analysis was conducted to explore the association between inflammatory biomarkers and the prevalence of hyperglycemic crises. Patients were followed up 6 months for outcomes.ResultsAmong 124 diabetic patients with COVID-19, 9 were diagnosed with DKA or HHS. Comparing COVID-19 without acute diabetic complications (ADC), patients with DKA or HHS showed elevated levels of c-reactive protein (CRP, P=0.0312) and procalcitonin (PCT, P=0.0270). The power of CRP and PCT to discriminate DKA or HHS with the area under the receiver operating characteristics curve (AUROC) were 0.723 and 0.794, respectively. Multivariate logistic regression indicated 1.95-fold and 1.97-fold increased risk of DKA or HHS with 1-unit increment of CRP and PCT, respectively. However, neither CRP nor PCT could predict poor outcomes in diabetic patients with COVID-19.ConclusionIn this small sample size study, we firstly found that elevated serum CRP and PCT levels increased the risk of hyperglycemic crises in T2DM patients with COVID-19 infection. More study is needed to confirm our findings. |
| first_indexed | 2024-03-07T23:00:56Z |
| format | Article |
| id | doaj.art-314a2d2d0d1e49e68bce641e50aa7cec |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-07T23:00:56Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-314a2d2d0d1e49e68bce641e50aa7cec2024-02-22T14:39:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-02-011510.3389/fendo.2024.12877951287795Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19Li-Chan Tao0Hong Shu1Ying Wang2Qian Hou3Jian-Jun Li4Xiao-Lin Huang5Fei Hua6Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaState Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaBackgroundInflammation is a predictor of severe complications in patients with COVID-19 infection under a variety of clinical settings. A few studies suggested that COVID-19 infection was a trigger of hyperglycemic crises including diabetic ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS). However, the association between inflammation and hyperglycemic crises in diabetic patients with COVID-19 infection is unclear.MethodsOne hundred and twenty-four patients with type 2 diabetes mellitus (T2DM) and COVID-19 infection from January 2023 to March 2023 were retrospectively analyzed. Demographic, clinical, and laboratory data, especially inflammatory markers including white blood cell (WBC), neutrophils, neutrophil-to-lymphocyte ratio (NLR), c-reactive protein (CRP) and procalcitonin (PCT) were collected and compared between patients with or without DKA and/or HHS. Multivariable logistic regression analysis was conducted to explore the association between inflammatory biomarkers and the prevalence of hyperglycemic crises. Patients were followed up 6 months for outcomes.ResultsAmong 124 diabetic patients with COVID-19, 9 were diagnosed with DKA or HHS. Comparing COVID-19 without acute diabetic complications (ADC), patients with DKA or HHS showed elevated levels of c-reactive protein (CRP, P=0.0312) and procalcitonin (PCT, P=0.0270). The power of CRP and PCT to discriminate DKA or HHS with the area under the receiver operating characteristics curve (AUROC) were 0.723 and 0.794, respectively. Multivariate logistic regression indicated 1.95-fold and 1.97-fold increased risk of DKA or HHS with 1-unit increment of CRP and PCT, respectively. However, neither CRP nor PCT could predict poor outcomes in diabetic patients with COVID-19.ConclusionIn this small sample size study, we firstly found that elevated serum CRP and PCT levels increased the risk of hyperglycemic crises in T2DM patients with COVID-19 infection. More study is needed to confirm our findings.https://www.frontiersin.org/articles/10.3389/fendo.2024.1287795/fullC-reactive proteinprocalcitonintype 2 diabetes mellitusdiabetic ketoacidosishyperglycemic hyperosmolar state |
| spellingShingle | Li-Chan Tao Hong Shu Ying Wang Qian Hou Jian-Jun Li Xiao-Lin Huang Fei Hua Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 Frontiers in Endocrinology C-reactive protein procalcitonin type 2 diabetes mellitus diabetic ketoacidosis hyperglycemic hyperosmolar state |
| title | Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 |
| title_full | Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 |
| title_fullStr | Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 |
| title_full_unstemmed | Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 |
| title_short | Inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with COVID-19 |
| title_sort | inflammatory biomarkers predict higher risk of hyperglycemic crises but not outcomes in diabetic patients with covid 19 |
| topic | C-reactive protein procalcitonin type 2 diabetes mellitus diabetic ketoacidosis hyperglycemic hyperosmolar state |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1287795/full |
| work_keys_str_mv | AT lichantao inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT hongshu inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT yingwang inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT qianhou inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT jianjunli inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT xiaolinhuang inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 AT feihua inflammatorybiomarkerspredicthigherriskofhyperglycemiccrisesbutnotoutcomesindiabeticpatientswithcovid19 |