High glycaemic variability is associated with progression of COVID-19

Hoong, Caroline Wei Shan; Yeo, Xi-Er; Lin, Yi Chun; Ooi, Say Tat; Yeoh, Ester

doi:10.1007/s00592-021-01779-7

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…Additionally, recently a few studies have been published that analysed individual metrics of glycaemic variability. For example, high inter-subject coefficient of variation and standard deviation have been associated with disease progression 35 and in-ICU mortality 36 in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study

Hartmann

Verket

Balfanz

et al. 2022

Sci Rep

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There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort study compared several metrics of glycaemic variability for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87–148] mmHg). Continuous HRs showed a proportional increase in mortality risk with daily glycaemic variability (DGV). Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P) < 0.001, LR(P) < 0.001; HR: 1.016, (P) = 0.001, LR(P) < 0.001, respectively). Kaplan–Meier estimators yielded a shorter median survival (25 vs. 87 days) and a higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5 mg/dl (P < 0.0001). High glycaemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, median procalcitonin and FPG.

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Section: Discussionmentioning

confidence: 99%

Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study

Hartmann

Verket

Balfanz

et al. 2022

Sci Rep

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Generally, glucose excursions and variability have been associated with increased oxidative stress, inflammatory cascade, overproduction of reactive oxygen species and endothelial activation [14,15]. They also increase the risk of hypoglycaemia, which can induce cardiovascular events and higher rates of mortality [7,16]. Studies have shown that high glucose variability is an adverse prognostic marker for the progression of COVID-19 independent of diabetes status, haemoglobin A1c (HbA 1c ) or mean glucose, highlighting the need for monitoring particularly among patients with pancreatic insufficiency or labile blood glucose levels [7,16].…”

Section: Discussionmentioning

confidence: 99%

“…glucose, highlighting the need of monitoring particularly among patients with pancreatic insufficiency or labile blood glucose levels [7,16].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Diabetes mellitus is a common comorbidity in hospitalised patients with COVID-19 pneumonia and a significant risk factor associated with increased rates of intubation and mortality [5]. Hyperglycaemia and, perhaps, excessive glucose levels/glycaemic variability represent independent predictors of mortality among critically ill patients [6,7]. Poor pre-infection glycaemic control and Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus HbA 1c > 9 % have been associated with more severe clinical outcomes [8].…”

Section: Introductionmentioning

confidence: 99%

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Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus

Petrakis

Panagopoulos

Trypsianis

et al. 2023

Exp Clin Endocrinol Diabetes

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Aim of the study: To evaluate fasting plasma glucose (FPG) increase and neutrophil to lymphocyte ratio (NLR) as risk predictors of severe clinical outcome of COVID-19 pneumonia in type 2 diabetes mellitus (T2DM) hospitalised patients. Patients and methods: Type 2 diabetes mellitus (T2DM) patients hospitalised with between March 2020 and February 2021 were studied retrospectively. The neutrophil to lymphocyte ratio at admission, as well as FPG increase (day 7, day with maximal FPG) were evaluated in association with clinical progression of SARS-CoV-2 infection. Results: Three hundred patients, 55% males, were included in the study. Mean age was 67.17±8.65 years. Severe COVID-19 pneumonia was diagnosed in 170 patients (56.7%). Fifty-four patients (18%) were intubated and 49 (16.3%) died. Greater increase in FPG (79.5 vs. 44.5 mg/dl for day 1-7, p<0.001; and 113.5 vs. 75 mg/dl for day 1-day with maximum glucose value, p<0.001) and higher NLR at admission (10.65 vs. 6.85) were seen in patients with need of high-flow oxygen compared to those without need, and they were associated with higher probability of intubation and death. Conclusion: FPG increase and NLR could be significant risk predictors of severe COVID-19 pneumonia in T2DM hospitalised patients.

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High glycemic variability is associated with a reduced T cell cytokine response to influenza A virus

Tong,

Hulme,

Law

et al. 2024

iScience

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High glycaemic variability is associated with progression of COVID-19

Cited by 7 publications

References 7 publications

Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study

Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study

Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus

High glycemic variability is associated with a reduced T cell cytokine response to influenza A virus

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