Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019.

Jiaoyue Zhang,An Pan,Lulu Chen,Han Wang,Zhenhai Cui,Wen Kong,Hui Sun,Hanyu Wang,Li Yang,Qin Li,Tianshu Zeng,Qi Wei,Yuxiu Wang,Kangli Qiu,Xueyu Zhong,Yumei Liu,Yu Hu,Si Xiong,Huiqing Li,Juan Zheng,Yan Li,Hua Liu,Li Li,Wenfang Xia,Xiaoguang Song ,Ying Xü ,Geng Li ,Peng‐Fei Xia

doi:10.3389/fendo.2020.00525

Abstract

Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19.Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models.Results: The median age of the patients was 57 years (interquartile range 38–66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48–8.40) and mortality (6.25; 1.91–20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15–14.74), after adjusting for age, sex, hospitals and comorbidities.Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.

Highlights

The coronavirus disease 2019 (COVID-19) pandemic, a public health emergency of international concern, had affected more than 8.1 million cases and caused over 440,000 deaths globally by June 18, 2020 [1]
Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is a risk factor for the poor outcomes of patients with COVID-19
Multivariable Cox regression analyses showed diabetes was IFG and Diabetes and the Severity of COVID-19 associated increased risks of primary composite end-point events and mortality (6.25; 1.91–20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15–14.74), after adjusting for age, sex, hospitals and comorbidities

Summary

Introduction

The coronavirus disease 2019 (COVID-19) pandemic, a public health emergency of international concern, had affected more than 8.1 million cases and caused over 440,000 deaths globally by June 18, 2020 [1]. Previous studies have reported that diabetes and uncontrolled glycemia were significant predictors of severity and mortality in patients infected with lower respiratory tract infections [7, 8], 2009 pandemic influenza A (H1N1) [9], severe acute respiratory syndrome coronavirus (SARS-CoV) [10], and Middle East respiratory syndrome coronavirus (MERS-CoV) [11, 12]. It remains controversial whether diabetes is related to adverse outcomes among patients with COVID-19 [13, 14]. We aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19

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Conclusion