Frontiers in Endocrinology (Jul 2020)

Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019

  • Jiaoyue Zhang,
  • Jiaoyue Zhang,
  • Wen Kong,
  • Wen Kong,
  • Pengfei Xia,
  • Ying Xu,
  • Li Li,
  • Qin Li,
  • Li Yang,
  • Qi Wei,
  • Hanyu Wang,
  • Hanyu Wang,
  • Huiqing Li,
  • Huiqing Li,
  • Juan Zheng,
  • Juan Zheng,
  • Hui Sun,
  • Hui Sun,
  • Wenfang Xia,
  • Wenfang Xia,
  • Geng Liu,
  • Geng Liu,
  • Xueyu Zhong,
  • Xueyu Zhong,
  • Kangli Qiu,
  • Kangli Qiu,
  • Yan Li,
  • Han Wang,
  • Han Wang,
  • Yuxiu Wang,
  • Yuxiu Wang,
  • Xiaoli Song,
  • Xiaoli Song,
  • Hua Liu,
  • Hua Liu,
  • Si Xiong,
  • Yumei Liu,
  • Zhenhai Cui,
  • Zhenhai Cui,
  • Yu Hu,
  • Yu Hu,
  • Lulu Chen,
  • Lulu Chen,
  • An Pan,
  • Tianshu Zeng,
  • Tianshu Zeng

DOI
https://doi.org/10.3389/fendo.2020.00525
Journal volume & issue
Vol. 11

Abstract

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Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19.Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models.Results: The median age of the patients was 57 years (interquartile range 38–66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48–8.40) and mortality (6.25; 1.91–20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15–14.74), after adjusting for age, sex, hospitals and comorbidities.Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.

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