The Relationship Between the Admission Blood Glucose Level and 90-Day Mortality in Non-Diabetic Patients with Coronavirus Disease-2019

Introduction: The admission blood glucose (ABG) level is associated with increased mortality in non-diabetics patients with Coronavirus disease-2019 (COVID-19) in short-term follow-up studies. However, post-discharge mortality has also increased in COVID-19. Thus, this study aimed to examine the relationship between ABG and 90-day mortality including the post-discharge period. Methods: Non-diabetic patients who are hospitalized due to COVID-19 in 2020 were evaluated. Patients were divided into groups according to the ABG level. Groups 1, 2, and 3 have ABG level of <100 mg/dL, 100-139 mg/dL, and 140-199 mg/dL, respectively. Intensive care unit admission, in-hospital mortality, and 30- and 90-day mortality rates were evaluated as outcomes. COX regression analyzes were used to assess mortality risk factors. Results: A total of 1207 non-diabetic patients, of whom 49.2% were females, with a mean age of 65.2±13.4 years, were included in the study. The patients were followed up for a median of 153 (inter quartile range: 107.5-251, maximum: 369) days. The in-hospital and 30-day mortality of group 2 was higher than group 1 in the univariate analysis but without statistical significance in multivariate analysis. Group 3 had worse outcomes than group 1 in both univariate and multivariate analysis at all endpoints. Group 3 had 2.533 adjusted hazard ratios (95% confidence interval: 1.628-3.941, p<0.001) 90-day mortality compared with group 1. Conclusion: Non-diabetic patients with COVID-19 with an admission glucose level of ≥140 mg/dl had 2.5-fold increased all-cause mortality at 90 days. Therefore, being more careful in treating and following non-diabetic patients with COVID-19, especially those with hyperglycemia at admission, was recommended. [ FROM AUTHOR] Copyright of Istanbul Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Preadmission usage of metformin and mortality in COVID-19 patients including the post-discharge period.

BACKGROUND: The effect of preadmission metformin usage (PMU) on the mortality of coronavirus disease-2019 (COVID-19) patients with diabetes is conflicting. Most studies have focused on in-hospital mortality; however, mortality after discharge also increases in COVID-19 patients. AIMS: Examining the effect of PMU on all-cause mortality, including the post-discharge period. METHODS: Patients with diabetes who were hospitalised in 2020 due to COVID-19 were included in the study. They were divided into two groups: those with a history of metformin use (MF( +)) and those without such history (MF( -)). Propensity score matching (PSM) was performed at a ratio of 1:1 for age and sex. COX regression analyses were used to demonstrate risk factors for mortality. RESULTS: We investigated 4103 patients hospitalised for COVID-19. After excluding those without diabetes or with chronic liver/kidney disease, we included the remaining 586 patients, constituting 293 women (50%) with an overall mean age of 66 ± 11.9 years. After PSM analysis, the in-hospital and post-discharge mortality rates were higher in the MF( -) group though not significantly different. However, overall mortality was higher in the MF( -) group (51 (42.5%) vs. 35 (29.2%), p = 0.031). For overall mortality, the adjusted HR was 0.585 (95% CI: 0.371 - 0.920, p = 0.020) in the MF( +) group. CONCLUSION: PMU is associated with reducing all-cause mortality. This effect starts from the in-hospital period and becomes more significant with the post-discharge period. The main limitations were the inability to evaluate the compliance with metformin and the effects of other medications due to retrospective nature.

Subacute thyroiditis after inactive SARS-CoV-2 vaccine.

Viral infections have often been associated with subacute (De Quervain) thyroiditis. Rare cases of subacute thyroiditis have been reported after vaccines. Various vaccines have been developed with different techniques against SARS-CoV-2. This case report presents a rare case of subacute thyroiditis after the inactive SARS-CoV-2 virus vaccine, CoronaVac.