Short- and long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes

Abstract

Background and aim To systematically evaluate the associations between glycemic control and short- to long-term outcomes in coronavirus disease 2019 (COVID-19) patients with type 2 diabetes (T2D). Design and methods A multi-center prospective cohort study including 574 COVID-19 patients with T2D were conducted in Wuhan, China. All patients were followed-up 1 year after hospital discharge using a uniformed questionnaire including self-reported symptoms, and the chronic obstructive pulmonary disease (COPD) assessment test (CAT) items. Results Of the 574 patients, 443 (77.2%) had well-controlled blood glucose. Glycemic control was significantly associated with decreased risk of death (OR: 0.24, 95% CI: 0.10-0.57), ICU admission (OR: 0.22, 95% CI: 0.10-0.49), invasive mechanical ventilation (OR: 0.25, 95% CI: 0.08-0.72), disease progression (OR: 0.25, 95% CI: 0.11-0.55), and composite outcome (OR: 0.26, 95% CI: 0.14-0.49). The top five long-term sequelae include fatigue (31.5%), sweating (21.2%), chest tightness (15.1%), anxiety (12.2%), myalgia (10.6%), and short breath (6.4%). Glycemic control was associated with decreased risk of respiratory sequelae (OR: 0.42, 95% CI: 0.18-0.99, P = 0.048). Conclusions Glycemic control was significantly associated with short-term outcomes in COVID-19 patients with T2D, and showed a significant association with long-term respiratory sequelae. The management and control of blood glucose has a positive impact on prognosis of COVID-19.

Response to: Comment on short- and long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes

“… 5 However, we first compared the characteristics between well-controlled and poorly controlled groups, with no significant difference in any pre-existing chronic diseases of the patients. 1 Due to the limited sample size in our study, too many correction terms may lead to a reduction of the statistical power to find the effect of interest. Lastly, all the clinical symptoms were checked first by experienced doctors during admission then recorded in electronic medical records.…”

“…We would like to thank Dr Chu for their comments about our recent original article ‘Short- to long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes’. 1 In response, we would like to add the following clarifications:…”

Correspondence: Short- and long-term prognosis of glycemic control in COVID-19 patients with type 2 diabetes

“…We read with great interest the prospective study by Zhan et al 1 investigating whether glycemic control upon admission has an impact on the short- and long-term prognosis among diabetic patients having coronavirus disease 2019 (COVID-19) infection. 1 They indicated that the benefit of well-controlled diabetes (i.e.…”

“…We read with great interest the prospective study by Zhan et al 1 investigating whether glycemic control upon admission has an impact on the short- and long-term prognosis among diabetic patients having coronavirus disease 2019 (COVID-19) infection. 1 They indicated that the benefit of well-controlled diabetes (i.e. less glycemic variability) was negatively correlated with critical outcomes such as disease progression, intensive care unit admission, invasive mechanical ventilation and death.…”

“…Third, considering the known association between the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and an increased risk of severe COVID-19 diseases, 4 the high prevalence of patients (around 60%) in the study by Zhan et al 1 may warrant a subgroup analysis focusing on antihypertensive medications to further explore this issue.…”