Hyperglycemia at hospital admission is associated with severity of the prognosis in patients hospitalized for COVID-19: The Pisa COVID-19 Study
To explore whether at-admission hyperglycemia is associated with worse outcomes in patients hospitalized for Covid-19.
RESEARCH DESIGN AND METHODS
Hospitalized Covid-19 subjects (N=271) were subdivided based on at-admission glycemic status: 1. glucose levels <7.78 mmol/L (NG; N=149; 55.0%; median glucose 5.99 [5.38-6.72] mmol/L), 2. known diabetes (DM; N=56; 20.7%; 9.18 [7.67-12.71] mmol/L), and 3. no diabetes and glucose levels ≥7.78 mmol/L (HG; N=66, 24.3%; 8.57 [8.18-10.47] mmol/L).
Neutrophils were higher and lymphocytes and PaO2/FiO2 lower in HG than DM and NG. DM and HG had higher D-Dimer and worse inflammatory profile. Mortality was greater in HG (39.4% vs 16.8%; unadjusted HR 2.20, 95%CI 1.27-3.81, p=0.005) than in NG (16.8%), and marginally so in DM (28.6%; HR 1.73, 0.92-3.25, p=0.086). Upon multiple adjustments, only HG remained an independent predictor (1.80, 1.03-3.15, p=0.04). After stratification by quintile of glucose levels, mortality was higher in Q4 (HR 3.57, 1.46-8.76, p=0.005) and marginally in Q5 (29.6%; HR 2.32, 95% CI 0.91-5.96, p=0.079) vs Q1.
Hyperglycemia is an independent factor associated with severe prognosis
in people hospitalized for COVID-19.