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Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study
Open accessAbstract
Hyperglycaemia is associated with an elevated risk of mortality in community-acquired pneumonia, stroke, acute myocardial infarction, trauma and surgery, among other conditions. In this study, we examined the relationship between fasting blood glucose (FBG) and 28-day mortality in coronavirus disease 2019 (COVID-19) patients not previously diagnosed as having diabetes. We conducted a retrospective study involving all consecutive COVID-19 patients with a definitive 28-day outcome and FBG measurement at admission from 24 January 2020 to 10 February 2020 in two hospitals based in Wuhan, China. Demographic and clinical data, 28-day outcomes, in-hospital complications and CRB-65 scores of COVID-19 patients in the two hospitals were analysed. CRB-65 is an effective measure for assessing the severity of pneumonia and is based on four indicators, i.e. confusion, respiratory rate (>30/min), systolic blood pressure (≤90 mmHg) or diastolic blood pressure (≤60 mmHg), and age (≥65 years). Six hundred and five COVID-19 patients were enrolled, including 114 who died in hospital. Multivariable Cox regression analysis showed that age (HR 1.02 [95% CI 1.00, 1.04]), male sex (HR 1.75 [95% CI 1.17, 2.60]), CRB-65 score 1–2 (HR 2.68 [95% CI 1.56, 4.59]), CRB-65 score 3–4 (HR 5.25 [95% CI 2.05, 13.43]) and FBG ≥7.0 mmol/l (HR 2.30 [95% CI 1.49, 3.55]) were independent predictors for 28-day mortality. The OR for 28-day in-hospital complications in those with FBG ≥7.0 mmol/l and 6.1–6.9 mmol/l vs <6.1 mmol/l was 3.99 (95% CI 2.71, 5.88) or 2.61 (95% CI 1.64, 4.41), respectively. FBG ≥7.0 mmol/l at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes. Glycaemic testing and control are important to all COVID-19 patients even where they have no pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders. Graphical abstract Graphical abstract
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
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Cited by
Global pandemics interconnected — obesity, impaired metabolic health and COVID-19
Stefan, N., Birkenfeld, A. L., & Schulze, M. B. (2021) · Nature Reviews Endocrinology · doi:10.1038/s41574-020-00462-1 · Cited by 452
COVID-19 and Diabetes: A Collision and Collusion of Two Diseases
Feldman, E. L., Savelieff, M. G., Hayek, S. S., Pennathur, S., Kretzler, M., & Pop-Busui, R. (2020) · Diabetes · doi:10.2337/dbi20-0032 · Cited by 136
Xia, S.-F., Maitiniyazi, G., Chen, Y., Wu, X.-Y., Zhang, Y., Zhang, X.-Y., Li, Z.-Y., Liu, Y., Qiu, Y.-Y., & Wang, J. (2022) · JMIR mhealth and uhealth · doi:10.2196/30571 · Cited by 40
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Metadata
- Authors
- Wang, S., Ma, P., Zhang, S., Song, S., Wang, Z., Ma, Y., Xu, J., Wu, F., Duan, L., Yin, Z., Luo, H., Xiong, N., Xu, M., Zeng, T., & Jin, Y.
- Venue
- Diabetologia
- Published
- 2020-07-10
- Volume
- 63
- Issue
- 10
- Pages
- 2102-2111
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W3041005642
- Cited by
- 325
- References
- 27
- FWCI
- 8.75
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Wang, S., Ma, P., Zhang, S., Song, S., Wang, Z., Ma, Y., Xu, J., Wu, F., Duan, L., Yin, Z., Luo, H., Xiong, N., Xu, M., Zeng, T., & Jin, Y. (2020). Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study. Diabetologia. https://doi.org/10.1007/s00125-020-05209-1
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