Hyperglycemic patients at high risk of COVID-19 complications

COVID-19 causes severe illness in patients with underlying illnesses such as diabetes, hypertension, severe lung disease, heart disease and weakened immunity.

Currently, a team of researchers at the Union Hospital of Huazhong University of Science and Technology and Tongji Medical University in Wuhan, China, are Hyperglycemia Higher risk of serious complications and more than double the risk of death.

Published in journal Diabetes, This study reflects previous studies on the association between hyperglycemia and severe COVID-19 complications.

Increased mortality risk

Studies to date have associated hyperglycemia or abnormally high blood glucose with an increased risk of death from acquired pneumonia (CAP), heart attack, stroke, and other medical conditions. Among pandemics, those with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had the highest mortality among older people and those with chronic illness.

Several studies have been associated with diabetes and poor outcome in COVID-19 patients. However, scientists have not established a direct correlation between fasting blood glucose (FBG) on admission and clinical outcome in patients without diagnosis of diabetes in COVID-19.

Investigation result

To reach their findings, the team investigated the relationship between FBG and 28-day mortality in patients with coronavirus disease who were not previously diagnosed with diabetes. They conducted a retrospective study of all consecutive COVID-19 patients admitted between January 24 and February 10 at two hospitals in Wuhan.

The researchers analyzed clinical and demographic data such as 28-day outcomes, CEB-65 scores, and nosocomial complications. The CRB-65 score measures the severity of pneumonia based on four indicators including respiratory rate, level of confusion, systolic or diastolic blood pressure, and age.

A total of 605 COVID-19 patients were enrolled, of whom 114 died in hospital. 34% of patients had one or more underlying disorders, with hypertension being the most common. At admission, about 29% were about 7.0 mmol/L, the highest category of FBG. Approximately 17% were in the pre-diabetic range and more than half were in the normal FBG range.

The results of the study also showed that patients in the highest FBG group were about 2.3 times more likely to die than those in the lowest group. In addition, people in the moderate-level FBG or prediabetes group were 71% more likely to die than those in the lowest group.

“For the first time, this study showed that elevated FBG (> 7.0 mmol/l) on admission was independent of the percentage of in-hospital complications in COVID-19 patients with an increased 28-day mortality rate and previous diagnosis of diabetes. It also shows that… FBGs of 7.0 mmol/l and above are associated with increased mortality, regardless of whether the patient has more or less severe pneumonia. I am.”

In addition, the data revealed that men were 75% more likely to die from COVID-19 than women, and those with a high CBR-64 score were more likely to die.

Potential mechanism

The team will also identify mechanisms that may contribute to an increased risk of death in diabetics. These include changes in coagulation caused by hyperglycemia, changes in vascular wall function, and overproduction of inflammatory cytokines. Cytokine storm..

Therefore, the team concluded that FBG> 7 mmol/L at admission was an independent predictor of 28-day mortality in COVID-19 patients, even if they had not been previously diagnosed with diabetes. Therefore, hospitals and clinicians should include blood glucose and blood glucose tests to determine the risk of patients with COVID-19 complications. Also, controlling blood sugar is essential to fight the new coronavirus and prevent complications.

Currently, the coronavirus pandemic has killed more than 571,000 people and infected more than 13 million people worldwide. The United States and Brazil were the hardest hit countries, with 3.36 million and 1.88 million respectively.