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Fasting plasma glucose and glucose fluctuation are associated with COVID-19 prognosis regardless of pre-existing diabetes.
Xie, Weijia; Wu, Na; Wang, Bin; Xu, Yu; Zhang, Yao; Xiang, Ying; Zhang, Wenjing; Chen, Zheng; Yuan, Zhiquan; Li, Chengying; Jia, Xiaoyue; Shan, Yifan; Xu, Bin; Bai, Li; Zhong, Li; Li, Yafei.
  • Xie W; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Wu N; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Wang B; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing 401120, People's Republic of China.
  • Xu Y; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing 401120, People's Republic of China.
  • Zhang Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Xiang Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Zhang W; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing 401120, People's Republic of China.
  • Chen Z; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Yuan Z; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Li C; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Jia X; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Shan Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Xu B; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China.
  • Bai L; Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of The Army Medical University, Chongqing 401120, People's Republic of China.
  • Zhong L; Cardiovascular Disease Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, People's Republic of China.
  • Li Y; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 401120, People's Republic of China. Electronic address: liyafei2008@tmmu.edu.cn.
Diabetes Res Clin Pract ; 180: 109041, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1401412
ABSTRACT

AIMS:

We aimed to investigate the role of Fasting Plasma Glucose (FPG) and glucose fluctuation in the prognosis of COVID-19 patients stratified by pre-existing diabetes.

METHODS:

The associations of FPG and glucose fluctuation indexes with prognosis of COVID-19 in 2,642 patients were investigated by multivariate Cox regression analysis. The primary outcome was in-hospital mortality; the secondary outcome was disease progression. The longitudinal changes of FPG over time were analyzed by the latent growth curve model in COVID-19 patients stratified by diabetes and severity of COVID-19.

RESULTS:

We found FPG as an independent prognostic factor of overall survival after adjustment for age, sex, diabetes and severity of COVID-19 at admission (HR 1.15, 95% CI 1.06-1.25, P = 1.02 × 10-3). Multivariate logistic regression analysis indicated that the standard deviation of blood glucose (SDBG) and largest amplitude of glycemic excursions (LAGE) were also independent risk factors of COVID-19 progression (P = 0.03 and 0.04, respectively). The growth trajectory of FPG over the first 3 days of hospitalization was steeper in patients with critical COVID-19 in comparison to moderate patients.

CONCLUSIONS:

Hyperglycemia and glucose fluctuation were adverse prognostic factors of COVID-19 regardless of pre-existing diabetes. This stresses the importance of glycemic control in addition to other therapeutic management.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Diabetes Res Clin Pract Journal subject: Endocrinology Year: 2021 Document Type: Article