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.
Subject(s)
Coronavirus Infections/mortality , Hyperglycemia/complications , Pneumonia, Viral/mortality , Registries , Aged , Aged, 80 and over , Blood Glucose , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Critical Care/statistics & numerical data , Female , Humans , Hyperglycemia/mortality , Length of Stay , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Respiration, Artificial/statistics & numerical data , Spain/epidemiologySubject(s)
Cytomegalovirus Infections/complications , Lymphoma, Large B-Cell, Diffuse/complications , Stomach Ulcer/microbiology , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antiviral Agents/therapeutic use , Cyclophosphamide/administration & dosage , Cytomegalovirus Infections/drug therapy , Doxorubicin/administration & dosage , Ganciclovir/analogs & derivatives , Ganciclovir/therapeutic use , Gastroscopy , Humans , Immunocompromised Host , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/pathology , Male , Middle Aged , Prednisone/administration & dosage , Remission Induction , Rituximab/administration & dosage , Stomach/pathology , Stomach Ulcer/complications , Valganciclovir , Vincristine/administration & dosageABSTRACT
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