Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients?
ABSTRACT Objective: Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients. Subjects and m...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
2023-07-01
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| Series: | Archives of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000600206&lng=en&tlng=en |
| _version_ | 1797788062206394368 |
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| author | Mariana Barbosa Juliana Marques-Sá Carla Carvalho Vera Fernandes |
| author_facet | Mariana Barbosa Juliana Marques-Sá Carla Carvalho Vera Fernandes |
| author_sort | Mariana Barbosa |
| collection | DOAJ |
| description | ABSTRACT Objective: Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients. Subjects and methods: Retrospective study including all adult COVID-19 patients admitted to a Portuguese hospital from March to August 2020 with BGA measurement. Subjects were categorized into two groups: BGA < 140 mg/dL and ≥ 140 mg/dL. Statistical analysis was performed using SPSSv26® (significance defined as p < 0.05). Results: We included 202 patients: median age 74 (60-86) years; 43.1% female; 31.2% with diabetes. The median BGA was 130.5 (108-158) mg/dL. When compared to normoglycemic, patients with BGA ≥ 140 mg/dL were older (p = 0.013), more vaccinated for influenza (p = 0.025) and had more comorbidities (hypertension, heart failure and peripheral arterial disease, p < 0.05). The last group presented higher leucocyte and neutrophile count, higher procalcitonin and prothrombin time, and lower lymphocyte count. Concerning prognosis, BGA ≥ 140 mg/dL was associated with higher rates of mechanical ventilation requirement and intensive care unit admission (p < 0.001), shock (p = 0.011), in-hospital mortality (p = 0.022) and 30-day mortality (p = 0.037). Considering only non-diabetic patients (n = 139), those with hyperglycemia presented higher rates of severity indicators (polypnea, SatO2 ≤ 93% and PaO2/FiO2 ≤ 300) and an association with poor outcomes was also found, namely mechanical ventilation requirement and in-hospital/30-day mortality (p < 0.05). Conclusion: Hyperglycemia at admission was associated with poor outcomes in COVID-19 patients, even in those without known pre-existing diabetes. Glycemic testing should be recommended for all COVID-19 patients. |
| first_indexed | 2024-03-13T01:31:12Z |
| format | Article |
| id | doaj.art-9c918f7893164fd8ac227fc0c94df500 |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-03-13T01:31:12Z |
| publishDate | 2023-07-01 |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-9c918f7893164fd8ac227fc0c94df5002023-07-04T07:47:30ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-42922023-07-0167610.20945/2359-3997000000649Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients?Mariana Barbosahttps://orcid.org/0000-0002-8604-6477Juliana Marques-Sáhttps://orcid.org/0000-0003-2193-1739Carla Carvalhohttps://orcid.org/0000-0003-0088-745XVera Fernandeshttps://orcid.org/0000-0002-9043-3867ABSTRACT Objective: Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients. Subjects and methods: Retrospective study including all adult COVID-19 patients admitted to a Portuguese hospital from March to August 2020 with BGA measurement. Subjects were categorized into two groups: BGA < 140 mg/dL and ≥ 140 mg/dL. Statistical analysis was performed using SPSSv26® (significance defined as p < 0.05). Results: We included 202 patients: median age 74 (60-86) years; 43.1% female; 31.2% with diabetes. The median BGA was 130.5 (108-158) mg/dL. When compared to normoglycemic, patients with BGA ≥ 140 mg/dL were older (p = 0.013), more vaccinated for influenza (p = 0.025) and had more comorbidities (hypertension, heart failure and peripheral arterial disease, p < 0.05). The last group presented higher leucocyte and neutrophile count, higher procalcitonin and prothrombin time, and lower lymphocyte count. Concerning prognosis, BGA ≥ 140 mg/dL was associated with higher rates of mechanical ventilation requirement and intensive care unit admission (p < 0.001), shock (p = 0.011), in-hospital mortality (p = 0.022) and 30-day mortality (p = 0.037). Considering only non-diabetic patients (n = 139), those with hyperglycemia presented higher rates of severity indicators (polypnea, SatO2 ≤ 93% and PaO2/FiO2 ≤ 300) and an association with poor outcomes was also found, namely mechanical ventilation requirement and in-hospital/30-day mortality (p < 0.05). Conclusion: Hyperglycemia at admission was associated with poor outcomes in COVID-19 patients, even in those without known pre-existing diabetes. Glycemic testing should be recommended for all COVID-19 patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000600206&lng=en&tlng=enHyperglycemiaSARS-CoV-2complicationsprognosis |
| spellingShingle | Mariana Barbosa Juliana Marques-Sá Carla Carvalho Vera Fernandes Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? Archives of Endocrinology and Metabolism Hyperglycemia SARS-CoV-2 complications prognosis |
| title | Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? |
| title_full | Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? |
| title_fullStr | Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? |
| title_full_unstemmed | Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? |
| title_short | Is elevated blood glucose at admission associated with poor outcomes in hospitalized COVID-19 patients? |
| title_sort | is elevated blood glucose at admission associated with poor outcomes in hospitalized covid 19 patients |
| topic | Hyperglycemia SARS-CoV-2 complications prognosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972023000600206&lng=en&tlng=en |
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