RT Journal Article
SR Electronic
T1 Elevation of blood glucose level predicts worse outcomes in hospitalized patients with COVID-19: a retrospective cohort study
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e001476
DO 10.1136/bmjdrc-2020-001476
VO 8
IS 1
A1 Jianfeng Wu
A1 Jianqiang Huang
A1 Guochao Zhu
A1 Qiongya Wang
A1 Qingquan Lv
A1 Ying Huang
A1 Yang Yu
A1 Xiang Si
A1 Hui Yi
A1 Cuiping Wang
A1 Yihao Liu
A1 Han Xiao
A1 Qian Zhou
A1 Xin Liu
A1 Daya Yang
A1 Xiangdong Guan
A1 Yanbing Li
A1 Sui Peng
A1 Joseph Sung
A1 Haipeng Xiao
YR 2020
UL http://drc.bmj.com/content/8/1/e001476.abstract
AB Introduction With intense deficiency of medical resources during COVID-19 pandemic, risk stratification is of strategic importance. Blood glucose level is an important risk factor for the prognosis of infection and critically ill patients. We aimed to investigate the prognostic value of blood glucose level in patients with COVID-19.Research design and methods We collected clinical and survival information of 2041 consecutive hospitalized patients with COVID-19 from two medical centers in Wuhan. Patients without available blood glucose level were excluded. We performed multivariable Cox regression to calculate HRs of blood glucose-associated indexes for the risk of progression to critical cases/mortality among non-critical cases, as well as in-hospital mortality in critical cases. Sensitivity analysis were conducted in patient without diabetes.Results Elevation of admission blood glucose level was an independent risk factor for progression to critical cases/death among non-critical cases (HR=1.30, 95% CI 1.03 to 1.63, p=0.026). Elevation of initial blood glucose level of critical diagnosis was an independent risk factor for in-hospital mortality in critical cases (HR=1.84, 95% CI 1.14 to 2.98, p=0.013). Higher median glucose level during hospital stay or after critical diagnosis (≥6.1 mmol/L) was independently associated with increased risks of progression to critical cases/death among non-critical cases, as well as in-hospital mortality in critical cases. Above results were consistent in the sensitivity analysis in patients without diabetes.Conclusions Elevation of blood glucose level predicted worse outcomes in hospitalized patients with COVID-19. Our findings may provide a simple and practical way to risk stratify COVID-19 inpatients for hierarchical management, particularly where medical resources are in severe shortage during the pandemic.