THU322 Lower HbA1c Is Associated With Lower In-Hospital Mortality In Patients With COVID-19

Abstract

Abstract Disclosure: M. Tsikala Vafea: None. M. Stefanovic-Racic: None. Introduction/Aim: Diabetes has been proven to be a risk factor for worse outcomes in patients with COVID-19. Several studies have shown that poor glycemic control during hospitalization with COVID-19 is associated with higher mortality. However, the association between a long-term glycemic control and outcomes has yet to be clarified, with some studies reporting no association. The aim of this study is to determine the association between glycosylated hemoglobin (HbA1c) and in-hospital mortality in patients with COVID-19. Methods: Pubmed, Embase and Web of Science databases were searched until 11/15/2022, for studies examining the association between HbA1c level and mortality in hospitalized patients with COVID-19. A random-effects meta-analysis was performed. Heterogeneity was assessed using the I2 statistic. Publication bias was assessed using funnel plots. Results: Among 4,142 results, 22 studies were included in the final analysis with a total of 11,998 patients. In the primary analysis, in studies comparing outcomes in patients using HbA1c as a dichotomous variable using specific cutoff values, lower Hba1c was associated with lower in-hospital mortality [odds ratio (OR) 0.52, 95% confidence interval (CI) 0.37-0.72]. Heterogeneity was substantial (I2 78%). When only patients with diabetes were included in the analysis, the association remained statistically significant (OR 0.70, 95% CI 0.51-0.98). In the subgroup analysis, the association remained statistically significant in studies using as cutoff the HbA1c value of 6.5% (OR 0.34, 95% CI 0.15-0.77) and 7% (OR 0.54, 95% CI 0.32-0.90). The association did not remain statistically significant with greater HbA1c cutoff values; 7.5% (OR 1.09, 95% CI 0.91-1.30) and >= 8% (OR 0.78, 95% CI 0.33-1.82). In the secondary analysis, in studies using HbA1C as a continuous variable, HbA1c level did not have a statistically significant association with in-hospital mortality, either in univariate (OR 0.97, 95% CI 0.92-1.03) or multivariate analyses (adjusted OR 1.00, 95% CI 1.00-1.01). Conclusion: A better glycemic control prior to hospitalization, as reflected by lower HbA1c, is associated with lower in-hospital mortality in patients with COVID-19. Presentation: Thursday, June 15, 2023