Assessment of risk, severity, mortality, glycemic control and antidiabetic agents in patients with diabetes and COVID-19: A narrative review

Singh, Awadhesh Kumar; Khunti, Kamlesh

doi:10.1016/j.diabres.2020.108266

Cited by 75 publications

(98 citation statements)

References 71 publications

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“…It is possible that the relatively small size among COVID-19 populations who with decreased glucose obscures the risk of hypoglycemia for COVID-19 patients. Many studies have demonstrated that hyperglycemia or diabetes is independent risk factor for the progression and mortality in patients with many infectious diseases such as SARS and COVID-19 [2][3][4][5][6][7]17]. Immune system dysregulation, rather than actual elevated glucose levels, may be the contributing factor of susceptibility to pathogen infection and severe conditions in diabetes patients [18].…”

Section: Discussionmentioning

confidence: 99%

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J-shaped association between fasting blood glucose levels and COVID-19 severity in patients without diabetes

Zhu

Jin

et al. 2020

Diabetes Research and Clinical Practice

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Coronavirus disease 2019 (COVID-19) has become a recognized worldwide pandemic. Researchers now know that mortality from COVID-19 can be reduced through early prevention measures. This retrospective, multi-centered study of 293 COVID-19 patients without diabetes explores the association between fasting blood glucose (FBG) levels and the risk of COVID-19 disease progression, with the goal of providing clinical evidence for glycemic targets in patients. Methods: The multivariate stepwise binary logistic regression analysis was used to test the dose-response effects of FBG levels on the risk of severe and critical condition in COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

“…Researchers are beginning to reach a consensus that COVID-19 patients with hyperglycemia or diabetes are associated with a higher risk of severely ill and mortality [2][3][4][5][6][7]. Wang and his colleagues have reported that COVID-19 patients with hyperglycemia or diabetes are more likely to need ICU care [8].…”

Section: Introductionmentioning

confidence: 99%

J-shaped association between fasting blood glucose levels and COVID-19 severity in patients without diabetes

Zhu

Jin

et al. 2020

Diabetes Research and Clinical Practice

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“…Studies showed that HDL was capable to bind and neutralize Gram-negative LPS and Gram-positive lipoteichoic acid (LTA), thus reducing LTA and LPSinduced in ammatory injury [38,39], thus providing the conception that HDL-based therapies might be promising in severe COVID-19 patients with bacterial co-infection. Diabetes was a common comorbidity in patients with COVID-19, and associated with greater disease severity and higher mortality of COVID-19 [40], especially in those population with poorly-controlled glycemia [41]. Several experimental studies have demonstrated that HDL particles displayed anti-diabetic properties by improving insulin sensitivity and β cell insulin secretion [9,42,43].…”

Section: Discussionmentioning

confidence: 99%

Changes in lipid metabolism in patients with severe COVID-19

Li¹,

Zhang²,

Dai³

et al. 2020

Preprint

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Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

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“…Comorbid conditions such as diabetes mellitus, respiratory, cardiovascular and renal illnesses, and obesity, and an older age group are known to be positively associated with poor outcomes among COVID-19 patients [10][11][12][13]. Furthermore, research studies have demonstrated that COVID-19 patients with diabetes have poorer clinical prognoses, are at higher risks of complications, such as respiratory failure and acute cardiac injury, and have shorter overall survival times than their non-diabetic counterparts [14].…”

Section: Introductionmentioning

confidence: 99%

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Acharya

Lee

et al. 2020

Healthcare

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Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.

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Assessment of risk, severity, mortality, glycemic control and antidiabetic agents in patients with diabetes and COVID-19: A narrative review

Cited by 75 publications

References 71 publications

J-shaped association between fasting blood glucose levels and COVID-19 severity in patients without diabetes

J-shaped association between fasting blood glucose levels and COVID-19 severity in patients without diabetes

Changes in lipid metabolism in patients with severe COVID-19

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

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