The association of hyperglycemia at hospital admission, clinical outcome and mortality in patients hospitalized for COVID 19 infection: Nakornping Hospital
Keywords:
COVID 19 infection, diabetes mellitus, hyperglycemia, disease outcome, mortalityAbstract
Objective: To evaluate the association between admission hyperglycemic patients hospitalized for moderate, severe and critical conditions of COVID 19 infection and clinical outcomes and mortality.
Methods: Patients hospitalized for COVID 19 infection from January 1, 2022 to June 30, 2022 were retrospectively reviewed and subdivided in three groups based on the admission glycemic status. Diabetes mellitus was defined as HbA1c ≥ 6.5 %. Hyperglycemia without known diabetes was defined as blood glucose ≥ 140 mg/dL for at least 2 separate measurements within any 24-hour period after admission while HbA1c < 6.5%. Normoglycemia was defined as blood glucose < 140 mg/dL and was considered as a control group. Clinical data including laboratory investigation, radiographic findings and clinical outcomes were compared. Fisher’s exact test and Kruskal-Wallis test were used.
Results: 357 COVID 19 patients were included. Two hundred and twelve patients (59.4%) were male. There were 123, 91, and 143 patients in diabetes, hyperglycemia without known diabetes and normoglycemia groups, respectively. When compared to normoglycemia group, hyperglycemia without known diabetes group had significantly higher number of patients who developed acute respiratory distress syndrome (ARDS) (adjusted OR 2.21, 95% CI 1.01-4.82, p = 0.047). To compare outcomes between 3 groups, mechanical ventilator needed was 70.33%, 56.10%, 43.36% (p ≤ 0.001), hospital mortality rate was 51.65%, 44.72%, 30.47% (p = 0.004) and duration of hospitalization was 10, 8, 7 days (p = 0.012), in diabetes, hyperglycemia without known diabetes and normoglycemia groups respectively.
Conclusion: Hyperglycemia without known diabetes has worse clinical outcomes during COVID 19 hospitalization. It is associated with higher rate of ARDS and the trend towards higher mortality.
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