Background: Hyperglycaemia is associated with worse outcomes in many settings. However, the association between dysglycaemia and adverse outcomes remains debated in COVID-19 patients. The objective of this study was to determine the association between prehospital blood glucose levels and acute medical unit (intensive care unit or high dependency unit) admission and mortality among COVID-19 infected patients.
Methods: This was a monocentric retrospective cohort study, based on patients taken care by the prehospital medical mobile unit from a Swiss university hospital between March 2020 and April 2021 All adult patients in whom a COVID-19 infection was confirmed or suspected during the study period a were included. Data were obtained from the prehospital medical files. The main exposure was prehospital blood glucose level. A 7.8mmol/l cut-off was used to define high blood glucose level. Restricted cubic splines were also used to analyse the exposure as a continuous variable. The primary endpoint was acute medical unit admission, and secondary endpoints were and 7-day and 30-day mortality. Multivariable logistic regressions were performed to compute odds ratios.
Results: A total of 276 patients were included. The mean prehospital blood glucose level was 8.8mmol/l, and 123 patients presented high blood glucose levels. The overall acute medical unit admission rate was 31.2%, with no statistically significant difference according to prehospital blood glucose levels. The mortality rate was 13.8% at seven days and 25% at 30 days. The mortality rate at 30 days was higher in patients with high prehospital blood glucose levels, with an adjusted odds-ratio of 2.5 (1.3 – 4.8).
Conclusions: In patients with acute COVID-19 infection, prehospital blood glucose levels do not seem to be associated with acute medical unit admission. An increased risk of 30-day mortality was however found in COVID-19 patients who presented high prehospital blood glucose levels.