Hyperglycemia is Associated With Increased Mortality in Critically Ill Patients With COVID-19.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2021 Feb

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To explore the relationship between hyperglycemia in the presence and absence of diabetes mellitus (DM) and adverse outcomes in critically ill patients with coronavirus disease 2019 (COVID-19). The study included 133 patients with COVID-19 admitted to an intensive care unit (ICU) at an urban academic quaternary-care center between March 10 and April 8, 2020. Patients were categorized based on the presence or absence of DM and early-onset hyperglycemia (EHG), defined as a blood glucose >180 mg/dL during the first 2 days after ICU admission. The primary outcome was 14-day all-cause in-hospital mortality; also examined were 60-day all-cause in-hospital mortality and the levels of C-reactive protein, interleukin 6, procalcitonin, and lactate. Compared to non-DM patients without EHG, non-DM patients with EHG exhibited higher adjusted hazard ratios (HRs) for mortality at 14 days (HR 7.51, CI 1.70-33.24) and 60 days (HR 6.97, CI 1.86-26.13). Non-DM patients with EHG also featured higher levels of median C-reactive protein (306.3 mg/L, P = .036), procalcitonin (1.26 ng/mL, P = .028), and lactate (2.2 mmol/L, P = .023). Among critically ill COVID-19 patients, those without DM with EHG were at greatest risk of 14-day and 60-day in-hospital mortality. Our study was limited by its retrospective design and relatively small cohort. However, our results suggest the combination of elevated glucose and lactate may identify a specific cohort of individuals at high risk for mortality from COVID-19. Glucose testing and control are important in individuals with COVID-19, even those without preexisting diabetes. Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved.

Citation

Alon Y Mazori, Ilana Ramer Bass, Lili Chan, Kusum S Mathews, Deena R Altman, Aparna Saha, Howard Soh, Huei Hsun Wen, Sonali Bose, Emily Leven, Jing Gennie Wang, Gohar Mosoyan, Pattharawin Pattharanitima, Giampaolo Greco, Emily J Gallagher. Hyperglycemia is Associated With Increased Mortality in Critically Ill Patients With COVID-19. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2021 Feb;27(2):95-100