Association between Hb A_1c and Severity of COVID-19 Patients

Abstract

This study aimed to examine the relationship between Hb A 1c levels and the clinical course of coronavirus-19 (COVID-19) patients. Sixty-six COVID-19(+) patients with high Hb A 1c and 46 with average Hb A 1c and 30 COVID-19(–) patients with average Hb A 1c were included. Hb A 1c levels and parameters examined in COVID-19(+) patients were compared between groups, and correlation analysis was performed between these parameters and Hb A 1c levels. The effect of Hb A 1c levels on intensive care unit (ICU) admission and mortality rate in COVID-19 patients was analyzed with the χ 2 test. It was observed that hemoglobin (Hb) and arterial oxygen saturation (SaO 2 ) levels of the COVID-19 (+) groups was lower than the COVID-19 (–) group, while ferritin, D-dimer, procalcitonin (PCT), and C-reactive protein (CRP) levels were higher. The COVID-19 (+) group with high Hb A 1c had higher lactate dehydrogenase (LDH), PCT and D-dimer levels than the other two groups, while Hb, partial arterial oxygen pressure (PaO 2 ) levels were lower. The Hb A 1c levels of the COVID-19 (+) groups were positively correlated with absolute neutrophil count (ANC), LDH, PCT and (K + ) levels, while negatively correlated with Hb and PaO 2 levels. Hb A 1c was found to be associated with the inflammation process, coagulation disorders and low PaO 2 in COVID-19 patients. The COVID-19 patients with high Hb A 1c levels had a higher mortality rate than other COVID-19 patients. Using Hb A 1c measurements with other prognostic markers would contribute to the patient’s risk of death assessment.

The epidemiological and clinical characteristics of COVID-19 in a high HIV/TB burden district level hospital setting

“…The cut-offHbA1c level of ≥6.5% is de ned as diabetes mellitus. A study revealed that high HbA1c level is associated with in ammation, hypercoagulability, and low SaO2 in COVID-19 patients, and the mortality rate is higher in patients with diabetes mellitus [44,45]. In our study, HbA1c was high in both discharged and death cases and the difference in HGT was not statistically signi cant between the two groups.…”

“…In our study, HbA1c was high in both discharged and death cases and the difference in HGT was not statistically signi cant between the two groups. The plausible explanation for the high HbA1c among COVID-19 cases with HIV could be more severe in ammatory process and more intense coagulation disorder associated with poor prognosis [45]. Another explanation could be the high HbA1c found in public sector primary health care facilities in Cape Town as a study showed 78.9% of type 2 diabetes mellitus patients had HbA1c outside of the target range [46].…”

Sweetness and positivity together aren't a happy ending: Case controlled study amongst severe COVID-19 for impact of diabetes mellitus on survival

“…The relation between the severity of diabetes (both in terms of HbA1C and duration of diabetes) and COVID outcomes has been published in the literature, wherein individuals with higher HbA1C and longer duration of diabetes were found to have higher mortality. 9 , 11 , 12 In our study, the mean HbA1C at admission was higher in individuals who succumbed to COVID vis-à-vis those who survived (9.0 vs. 7.89%, p-0.1456). But, we didn't elaborate on the relationship between HbA1C and outcomes, as we could perform HbA1C of only 93 patients at admission, whereas for the rest of the individuals, the reports were based on medical records (with few being more than a month old).…”

“…The relationship between the severity of COVID in Diabetics independent of confounding variables such as age and gender has not been studied extensively from India and hence merits further research. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 …”

HbA1c level may be a risk factor for oxygen therapy requirement in patients with coronavirus disease 2019

“…Many clinical studies and meta-analyses have identified significant predictors or risk factors for the severity or mortality of COVID-19, including age, male sex, obesity, white blood cell (WBC) count, and serum levels of C-reactive protein (CRP) and D-dimer [1][2][3][4] . In addition, diabetes-related parameters, including fasting plasma glucose and glycated hemoglobin (HbA1c) levels, and comorbidities including hypertension, respiratory diseases, chronic heart disease, liver disease, cardiovascular disease, and stroke, are also helpful in predicting the severity and mortality of COVID-19 [4][5][6][7][8] . However, these parameters are absolutely associated with the severity of COVID-19, that is, the risk of ICU admission or death as the study outcome.…”