Influence of Fasting Plasma Glucose Level on Admission of COVID-19 Patients: A Retrospective Study

Abstract

Background. The coronavirus disease 2019 (COVID-19) is a serious global health threat and has spread dramatically worldwide. Prolonged viral shedding is associated with a more severe disease course and inflammatory reaction. Blood glucose levels were significantly associated with an increased hazard ratio (HR) for poor outcomes in COVID-19 patients. Objective. Previous studies focused primarily on the relationship between blood glucose and mortality or severe outcomes, but there were few research studies on the relationship between fasting plasma glucose (FPG) and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA positive status. To explore the relationship between FPG levels and prolonged duration of SARS-CoV-2 viral positivity, the clinical data of COVID-19 patients were analyzed. Method. In this retrospective study, 99 cases of COVID-19 patients in Beijing Ditan Hospital were recruited, and their clinical and laboratory findings at admission were collected and analyzed. Furthermore, the risk factors for prolonged duration of SARS-CoV-2 RNA shedding were identified, and the relationship between FPG levels and the prolonged presence of SARS-CoV-2 RNA was evaluated. Result. We found that elevated FPG levels were correlated with longer duration of SARS-CoV-2 RNA positivity, classification of COVID-19, imaging changes of chest CT, inflammation-related biomarkers, and CD8+ T cell number in COVID-19 patients. In a logistic regression model, after adjusting for gender and age, COVID-19 patients with elevated FPG were more likely to had longer duration of SARS-CoV-2 RNA positivity than those with normal FPG levels (OR 3.053 [95% CI 1.343, 6.936]). Conclusion. Higher FPG levels (≥6.1 mmol/l) at admission was an independent predictor for prolonged SARS-CoV-2 shedding, regardless of a known history of diabetes. It suggests that intensive monitoring and control of blood glucose are important for all COVID-19 patients.

Old Age is an Independent Risk Factor for Pneumonia Development in Patients with SARS-CoV-2 Omicron Variant Infection and a History of Inactivated Vaccine Injection

“…The glucose level correlated with the poor outcome and prolonged SARS-CoV-2 shedding in Delta variant-infected patients. [19][20][21][22] Patients with lower uric acid levels were more likely to have severe symptoms. 23,24 It was speculated that the cellular and humoral immunity was impaired and the level of neutralizing antibodies reduced with age.…”

Age-related influence on DNA damage, proteomic inflammatory markers and oxidative stress in hospitalized COVID-19 patients compared to healthy controls

“…It is very well known that the severity of COVID-19 infections is strongly influenced by comorbidities such as T2DM or cardiovascular disease that might lead to hospitalization during acute infections [ [1] , [2] , [3] ]. Interestingly, one retrospective study with 99 clinical COVID-19 patients found a relationship between fasting glucose levels and Sars-Cov2 duration that leads to the assumption that increased FPG levels are associated with a longer duration of SARS-CoV-2 RNA positivity in patients [ 67 ].…”

SARS-CoV-2 omicron variant clearance delayed in breakthrough cases with elevated fasting blood glucose

“…Several studies indicated that glucose at admission is an independent risk factor for the poor prognosis of COVID-19 during the Delta variant wave [ 15 , 16 , 20 ]. Moreover, high glucose at admission is an independent predictor for prolonged SARS-CoV-2 shedding, irrespective of a history of diabetes [ 17 ]. Similar results were obtained in the present study during the Omicron variant wave.…”

“…Based on previous studies, blood glucose predicted the mortality of coronavirus disease 2019 (COVID-19), even in patients without a history of diabetes [ 14 – 16 ]. High fasting plasma glucose level (≥ 6.1 mmol/L) at admission is an independent predictor for prolonged SARS-CoV-2 shedding [ 17 ]. Individuals with hyperglycemia had lower spike IgG titer than those with normoglycemia after two doses of the BNT162b2 vaccine, indicating that hyperglycemia is associated with a poor humoral immune response [ 18 ].…”