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J-shaped associations and joint effects of fasting glucose with inflammation and cytokines on COVID-19 mortality.
Lai, Xuefeng; Deng, Shan; Hu, Lizhi; Chen, Ru; Chen, Min; Liang, Minglu; Hou, Jian; Huang, Kai; Zhang, Xiaomin.
  • Lai X; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Deng S; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Hu L; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Chen R; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Chen M; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Liang M; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Hou J; Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
  • Huang K; Clinic Center for Human Genomic Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: huangkai1@
  • Zhang X; Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: mingxz117@163.com.
Int J Infect Dis ; 122: 285-294, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1867239
ABSTRACT

OBJECTIVES:

The aim of this study was to investigate the dose-response relationship of admission fasting glucose (FBG) with corona virus disease 2019 (COVID-19) mortality and to further evaluate potential interactions of hyperglycemia with inflammation and hypercoagulation on COVID-19 outcomes.

METHODS:

This retrospective study included 2555 consecutively hospitalized patients with COVID-19, until death or discharge, in Wuhan Union hospital between January 1 and April 9, 2020. The poor early outcomes included admission to intensive care unit, intubation, and deaths occurring within 28 days. We used splines nested in Cox regression to visualize dose-response associations and generalized additive models to fit three-dimensional (3D) trend plots for joint effects of FBG with markers of inflammation and coagulation.

RESULTS:

J-shaped associations existed between hospitalized mortality or poor early outcomes and FBG with a nadir at 5 mmol/L, which were more evident in women. 3D plots demonstrated significant joint effect trends, and patients with hyperglycemia and high neutrophil-lymphocyte ratio, C-reactive protein, lactate dehydrogenase, procalcitonin, d-dimer, and interleukin-6 had 7.4-25.3-fold risks; the proportions of joint associations attributed to additive interactions reached 30% to 54%.

CONCLUSIONS:

FBG was associated with hospitalized mortality and poor early outcomes in a J-shaped manner, and a combination of hyperglycemia, inflammation, hypercoagulation, and cytokines conferred a dramatically higher risk.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hyperglycemia Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: J.ijid.2022.05.060

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hyperglycemia Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans Language: English Journal: Int J Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: J.ijid.2022.05.060