Wuhan, China: Researchers have found in a new study that blood sugar fluctuations in first week of hospitalized COVID-19 patients was linked to high morbidity and mortality.Therefore early optimization of blood sugar control strategies may be beneficial in hospitalized COVID-19 patients, suggests a recent study in the journal Diabetes Care.
Liangkai Chen, Huazhong University of Science and Technology, Wuhan, China, and colleagues aimed to investigate the association of in-hospital early-phase glycemic control with adverse outcomes among inpatients with coronavirus disease 2019 (COVID-19) in Wuhan, China.
The data were obtained regarding consecutive patients hospitalized with COVID-19 in the Central Hospital of Wuhan between 2 January and 15 February 2020. It included patients with definite outcomes (death or discharge). Using electronic medical records, the researchers extracted demographic, clinical, treatment, and laboratory information of the patients. Also, data was collected daily on fasting glucose from standard morning fasting blood biochemistry to determine glycemic status and fluctuation (calculated as the square root of the variance of daily fasting glucose levels) during the 1st week of hospitalization.
The study included a total of 548 patients, 215 suffered acute respiratory distress syndrome (ARDS), 489 survived, and 59 died.
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Key findings of the study include:
Patients who had higher mean levels of glucose during their 1st week of hospitalization were older and more likely to have a comorbidity and abnormal laboratory markers, prolonged hospital stays, increased expenses, and greater risks of severe pneumonia, ARDS, and death.
Compared with patients with the lowest quartile of glycemic fluctuation, those who had the highest quartile of fluctuation magnitude had an increased risk of ARDS (risk ratio 1.97) and mortality (hazard ratio 2.73).
Higher blood sugar levels in first week of hospitalization of COVID 19 had a prolonged stay at the hospital and a greater risk of severe pneumonia, acute respiratory distress syndrome, and death.ln addition to this, a greater degree of fluctuations in blood sugar levels was associated with an increased risk of acute respiratory distress syndrome and death. These findings suggest that strategies focusing on early glycemic management in hospitalized COVID-19 patients may be beneficial.
"These results may have implications for optimizing glycemic control strategies in COVID-19 patients during the early phase of hospitalization," concluded the authors.
The study titled, "Association of Early-Phase In-Hospital Glycemic Fluctuation With Mortality in Adult Patients With Coronavirus Disease 2019," is published in the journal Diabetes Care.