1420-P: Predictors of Readmission and Mortality in Adults with Diabetes or Stress Hyperglycemia after Initial Hospitalization for COVID-19

Abstract

Our consortium previously reported that older age, elevated glycemic gap, higher BMI and DKA on admission predicted mortality in adults with diabetes or stress hyperglycemia (glucose >180 mg/dl twice in 24 hrs) admitted with COVID-19 from March 2020 - February 2021 to 5 university hospitals. Here we examine those from this cohort who were readmitted (19.4%) after their initial discharge (Table). Of those readmitted 90.3% were readmitted within 30 days [median (IQR) 4 (0, 14) days]. Older age, lower eGFR, comorbidities, ICU admission, mechanical ventilation, DKA and longer length of stay during the initial hospitalization were associated with readmission. Higher A1c and admission glucose, diagnosed diabetes, glycemic gap and BMI did not predict increased risk of readmission. Hispanics were less likely to be readmitted. Mortality during readmission was 8.0%. Those who died were older than those who survived (74.9±9.5 vs 65.2±14.4 yrs, p= 0.002) and were more likely to have had DKA during the first hospitalization (p< 0.001). Mortality analyses were limited by the small number of deaths (n=23). In conclusion, in adults with diabetes or stress hyperglycemia hospitalized with COVID-19, older age and non-glycemic comorbidities were associated with the risk of readmission, while glycemic gap and higher A1c were not. These results are important for guiding treatment strategies. Disclosure A.S.Chaugule: None. G.P.Westcott: None. R.S.Weinstock: Consultant; Jaeb Center for Health Research, Other Relationship; Wolters Kluwer Health, Research Support; Insulet Corporation, Medtronic, Eli Lilly and Company, Novo Nordisk, Boehringer Ingelheim Inc., Hemsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, Tandem Diabetes Care, Inc., Kowa Pharmaceuticals America, Inc. K.Howard: None. D.C.Simonson: Stock/Shareholder; Phase V Technologies, Inc., GI Windows. M.E.Mcdonnell: None. R.K.Garg: None. G.Gopalakrishnan: Research Support; Spruce Biosciences, Sparrow Pharmaceuticals Inc, Medtronic. J.Mitri: Other Relationship; Novo Nordisk, Research Support; Kowa Company, Ltd. J.Lebastchi: None. N.E.Palermo: Research Support; Dexcom, Inc.