Admission hyperglycaemia as a predictor of mortality in patients hospitalized with COVID-19 regardless of diabetes status: data from the Spanish SEMI-COVID-19 Registry

Francisco Javier Carrasco-Sánchez, Mª Dolores López-Carmona, Francisco Javier Martínez-Marcos, Luis M. Pérez-Belmonte, Alicia Hidalgo-Jiménez, Verónica Buonaiuto, Carmen Suárez Fernández, Santiago Jesús Freire Castro, Davide Luordo, Paula Maria Pesqueira Fontan, Julio César Blázquez Encinar, Jeffrey Oskar Magallanes Gamboa, Andrés de la Peña Fernández, José David Torres Peña, Joaquim Fernández Solà, Jose Javier Napal Lecumberri, Francisco Amorós Martínez, María Esther Guisado Espartero, Carlos Jorge Ripper, Raquel Gómez MéndezNatalia Vicente López, Berta Román Bernal, María Gloria Rojano Rivero, José Manuel Ramos Rincón, Ricardo Gómez Huelgas

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5 Scopus citations

Abstract

Background: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. Methods: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140–180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. Results: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140–180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31–1.73) (BG 140–180 mg/dL; HR 1.48; 95%CI: 1.29–1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. Conclusions: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes.KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.
Original languageEnglish
JournalAnnals of Medicine
Volume53
Issue number1
DOIs
StatePublished - 1 Jan 2021

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