Fasting Plasma Glucose Level Independently Predicts the Mortality of Patients with Coronavirus Disease 2019 Infection: A Multicenter, Retrospective Cohort Study

Abstract

Background: Coronavirus disease 2019 (COVID-19) has become a global pandemic, which prompts a consensus for the necessity to seek risk factors for this critical disease. Risk factors affecting mortality of the disease remain elusive. Diabetes and hyperglycemia are known to negatively affect a host's antiviral immunity. We evaluated the relationship between a history of diabetes, fasting plasma glucose (FPG) levels and mortality among severely ill patients with COVID-19. Methods: This was a retrospective cohort study that assessed 106 adult inpatients (aged ≥18 years) from two tertiary hospitals in Daegu, South Korea. The participants were transferred to tertiary hospitals because their medical condition required immediate intensive care. The demographic and laboratory data were compared between COVID-19 patients who survived and those who did not. Results: Compared with the survivor group, age, and the proportions of diabetes, chronic lung disease and FPG were significantly higher in the deceased group. In the Cox proportional hazards regression model for survival analysis, FPG level and age were identified as significant predictors of mortality (P<0.05). The threshold values for predicting high mortality were age >68 years and FPG of 168 mg/dL, respectively. Among those without diabetes, high FPG remained a significant predictor of mortality (P<0.04). Conclusion: High FPG levels significantly predicted mortality in COVID-19, regardless of a known history of diabetes. These results suggest intensive monitoring should be provided to COVID-19 patients who have a high FPG level.

High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis

“…Furthermore, we discovered that the smallersized studies yielded excessively wide CIs as compared to larger studies (Table 1). Nonetheless, sensitivity analysis suggested that these small studies did not contribute much to the pooled estimate as our findings remained consistent, except when Fadini et al [36] or Chang et al [38] were excluded, which exaggerated the pooled estimates (Appendix Figure S2B). We detected asymmetry in the funnel plot which was further ascertained by Egger's test (P<0.001; Appendix Figure S3), although Begg's test indicated otherwise (P=0.245), suggesting the presence of publication bias.…”

“…Although our findings also favored the use of admission RBG, future research are required as we were unable to comprehensively explore the independent prognostic value of admission RBG due to paucity of studies. Furthermore, the current evidence indicated that the cut-off values to predict poor prognosis in COVID-19 patients are still equivocal [38,41,52,53], suggesting that future large multicenter studies are required to obtain the most optimum cut-off value.…”

Incidence of Post-Traumatic Stress Disorder after Coronavirus Disease

“…To date, several studies have reported risk factors for COVID-19's progression, such as age, hypertension, use of angiotensin-converting enzyme inhibitors, and neurological disorders [8,[10][11][12][13]. For example, young individuals infected with SARS-CoV-2 generally show milder respiratory symptoms than older adults [13].…”

High admission blood glucose is an independent risk factor of poor prognosis in COVID-19: A systematic review and dose-response meta-analysis

“…From 35 included studies, more than half were conducted in China (23 studies), while the others were five each in America 18,21,[27][28][29] and Europe 20,25,[30][31][32] , and one each in Hong Kong 33 and South Korea 34 . FBG was utilized in 23 studies, while RBG in 13 studies.…”