Prognostic value of fasting hyperglycemia in patients with COVID-19 – Diagnostic test accuracy meta-analysis

Handayani, Dewi Ratih; Juliastuti, Henny; Nawangsih, Eka Noneng; Kusmala, Yudith Yunia; Rakhmat, Iis Inayati; Wibowo, Arief; Pranata, Raymond

doi:10.1016/j.obmed.2021.100333

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…In keeping with these results, some latest meta-analyses and studies showed sufficient data regarding the topic ( 109 – 112 ). The first one demonstrated associated DM and hyperglycemia in 19.70% (CI: 10.93-32.91) and 25.23% (CI: 19.07-32.58) of COVID-19 cases, respectively ( 110 ).…”

Section: Metabolic Outcomes Of Covid-19supporting

confidence: 61%

Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications

Gerganova

Assyov

Kamenov

2022

Front. Clin. Diabetes Healthc.

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The novel severe acute respiratory distress syndrome-coronavirus 2 (SARS-CoV-2) has caused one of the most substantial pandemics that has affected humanity in the last century. At the time of the preparation of this review, it has caused the death of around 5 million people around the globe. There is ample evidence linking higher mortality risk rates from Coronavirus disease-19 (COVID-19) with male gender, advancing age and comorbidities, such as obesity, arterial hypertension, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, and cancer. Hyperglycemia has been found to be accompanying COVID-19 not only in individuals with overt diabetes. Many authors claim that blood glucose levels should also be monitored in non-diabetic patients; moreover, it has been confirmed that hyperglycemia worsens the prognosis even without pre-existing diabetes. The pathophysiological mechanisms behind this phenomenon are complex, remain controversial, and are poorly understood. Hyperglycemia in the setting of COVID-19 could be a consequence of deterioration in pre-existing diabetes, new-onset diabetes, stress-induced or iatrogenic due to substantial usage of corticosteroids within the context of a severe COVID-19 infection. It is also plausible that it might be a result of adipose tissue dysfunction and insulin resistance. Last but not least, SARS-CoV-2 is also claimed to trigger sporadically direct β-cell destruction and β-cell autoimmunity. Pending further validations with longitudinal data are needed to legitimize COVID-19 as a potential risk factor for the development of diabetes. Hereby, we present an emphasized critical review of the available clinical data in an attempt to unravel the complex mechanisms behind hyperglycemia in COVID-19 infection. The secondary endpoint was to evaluate the bidirectional relationship between COVID-19 and diabetes mellitus. As the worldwide pandemic is still expanding, demand for answering these questions is arising. It will be of immense help for the management of COVID-19 patients, as well as for the implementation of post-discharge policies for patients with a high risk of developing diabetes.

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Section: Metabolic Outcomes Of Covid-19supporting

confidence: 61%

Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications

Gerganova

Assyov

Kamenov

2022

Front. Clin. Diabetes Healthc.

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“…In the present study, the association with severe COVID‐19 progression was weaker for higher RPG than for higher HbA1c level on admission (Table 3). Although previous meta‐analyses have shown fasting plasma glucose level to be associated with COVID‐19 prognosis 36,37 , no such findings have shown a robust association of admission RPG level 36 . Determination of fasting plasma glucose rather than RPG at the time of admission might be more important for predicting the prognosis of COVID‐19, as well as analysis of the association of HbA1c or plasma glucose level in affected patients.…”

Section: Discussionmentioning

confidence: 98%

Glycated hemoglobin level on admission associated with progression to severe disease in hospitalized patients with non‐severe coronavirus disease 2019

Numaguchi¹,

Kurajoh²,

Hiura³

et al. 2022

J of Diabetes Invest

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Aims/Introduction Poor glycemic control is known to be associated with severe infection development. This retrospective observational study examined whether glycemic control before coronavirus disease 2019 (COVID‐19) onset contributes to progression from non‐severe to severe COVID‐19. Materials and Methods Glycated hemoglobin (HbA1c) was measured on hospital admission in 415 patients with non‐severe COVID‐19. The outcome was determined from time of hospital admission to severe progression, based on clinical practice guidelines for COVID‐19 in Japan. Results The median value for HbA1c on admission was 6.1%, with diabetes present in 138 patients (33.3%). Among the total cohort, 93 (22.4%) progressed to severe COVID‐19 with a median (interquartile range) time of 4 days (3–7 days), whereas 322 (77.6%) were discharged after 13 days (10–17 days). A multivariable Cox proportional hazards regression model showed that HbA1c level on admission was independently associated with progression to severe COVID‐19 (hazard ratio for 1% increase 1.237, 95% confidence interval 1.037–1.475; P = 0.018), with findings consistent among several sensitivity analyses. In subgroup analyses, such an association was significant in patients with diabetes, as well as older age, current smoking habit, lower estimated glomerular filtration rate, higher C‐reactive protein level, moderate II COVID‐19, dyslipidemia and chronic respiratory disease, with no remarkable inconsistency among the subgroups. Finally, higher HbA1c level (≥7%) was more strongly associated with severe COVID‐19 progression than diabetes. Conclusions The results suggest that poor glycemic control before COVID‐19 onset contributes to progression from non‐severe to severe COVID‐19, even in patients with severe COVID‐19 risk factors regardless of the presence of diabetes.

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“…The finding of lower soluble DPP-IV receptor in COVID-19 in compare to healthy subject might also indicates the role of DPP-IV in facilitating viral entry although the exact interactions between DPP-IV and coronavirus and how it influence the viral entry has not been established [ [59] , [60] , [61] ]. However, since poor glucose control, cytokine storm, and multiorgan dysfunction have been established as a risk factor for worse outcome [ 40 , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] ], one might consider the benefit of excellent glucose control, cardiorenal effect and inflammatory modulation of DPP-IV inhibitor as an potential drug in treating T2DM patient with COVID-19 [ 5 , 75 ].…”

Section: Discussionmentioning

confidence: 99%

Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 — A systematic review and meta-analysis

Zein

Raffaello

2022

Primary Care Diabetes

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Introduction This systematic review and meta-analysis aimed to synthesize the latest evidence on the effect of dipeptidyl peptidase-4 (DPP-IV) inhibitor in patients with COVID-19. Methods We performed a systematic literature search from the PubMed, Scopus, Embase, and Clinicaltrials.gov up until 15 July 2021. Studies that met the following criteria were included: prospective or retrospective observational studies or case series or randomized controlled trials (RCTs) reporting DPP-IV inhibitor use in patients with COVID-19 and mortality. The intervention group was patients receiving DPP-IV inhibitor. The control group was patients that did not receive DPP-IV inhibitor. The outcome was mortality reported as odds ratio (OR). Results There were 11 studies consisting of 5,950 patients in this meta-analysis. DPP-IV inhibitor use was associated with reduced mortality (OR 0.75 [0.56, 0.99], p = 0.043, I 2 : 42.9, p = 0.064) compared to those that did not receive DPP-IV inhibitor. Sensitivity analysis using the fixed-effect model (OR 0.75 [0.63, 0.88], p < 0.001, I 2 : 42.9, p = 0.064) also showed mortality benefit. The association between DPP-IV inhibitor and mortality was not significantly affected by age (p = 0.540), sex (p = 0.054), hypertension (p = 0.320), location (continent; p = 0.532), and retrospective/prospective nature of the study (p = 0.840). However, the association was affected by metformin (OR 1.03 [95% CI 1.01, 1.06], p = 0.010) and ACEI/ARB use (OR 1.06 [95% CI 1.02, 1.10], p = 0.004). Conclusion This meta-analysis showed that DPP-IV inhibitor was associated with reduced mortality in patients with COVID-19.

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Prognostic value of fasting hyperglycemia in patients with COVID-19 – Diagnostic test accuracy meta-analysis

Cited by 7 publications

References 34 publications

Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications

Stress Hyperglycemia, Diabetes Mellitus and COVID-19 Infection: Risk Factors, Clinical Outcomes and Post-Discharge Implications

Glycated hemoglobin level on admission associated with progression to severe disease in hospitalized patients with non‐severe coronavirus disease 2019

Dipeptidyl peptidase-4 (DPP-IV) inhibitor was associated with mortality reduction in COVID-19 — A systematic review and meta-analysis

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