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Haemoglobin A1c is a predictor of COVID-19 severity in patients with diabetes.
Merzon, Eugene; Green, Ilan; Shpigelman, Miriam; Vinker, Shlomo; Raz, Itamar; Golan-Cohen, Avivit; Eldor, Roy.
  • Merzon E; Medical Division, Leumit Health Services, Tel-Aviv, Israel.
  • Green I; Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Shpigelman M; Medical Division, Leumit Health Services, Tel-Aviv, Israel.
  • Vinker S; Leumit Health Services, Central District Headquarter, Netanya, Israel.
  • Raz I; Medical Division, Leumit Health Services, Tel-Aviv, Israel.
  • Golan-Cohen A; Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Eldor R; The Pesach Segal Israeli Center for Diabetes Research and Policy, Sheba Medical Center, Ramat Gan, Israel.
Diabetes Metab Res Rev ; 37(5): e3398, 2021 07.
Article in English | MEDLINE | ID: covidwho-802276
ABSTRACT

AIM:

Poor outcomes of coronavirus disease 2019 (COVID-19) have been linked to diabetes, but its relation to pre-infection glycaemic control is still unclear. MATERIALS AND

METHODS:

To address this question, we report here the association between pre-infection Haemoglobin A1c (HbA1c) levels and COVID-19 severity as assessed by need for hospitalization in a cohort of 2068 patients with diabetes tested for COVID-19 in Leumit Health Services (LHSs), Israel, between 1 February and 30 April 2020. Using the LHS-integrated electronic medical records system, we were able to collect a large amount of clinical information including age, sex, socio-economic status, weight, height, body mass index, HbA1c, prior diagnosis of ischaemic heart disease, depression/anxiety, schizophrenia, dementia, hypertension, cerebrovascular accident, congestive heart failure, smoking, and chronic lung disease.

RESULTS:

Of the patients included in the cohort, 183 (8.85%) were diagnosed with COVID-19 and 46 were admitted to hospital. More hospitalized patients were female, came from higher socio-economic background and had a higher baseline HbA1c. A prior diagnosis of cerebrovascular accident and chronic lung disease conferred an increased risk of hospitalization but not obesity or smoking status. In a multivariate analysis, controlling for multiple prior clinical conditions, the only parameter associated with a significantly increased risk for hospitalization was HbA1c ≥ 9%.

CONCLUSION:

Using pre-infection glycaemic control data, we identify HbA1c as a clear predictor of COVID-19 severity. Pre-infection risk stratification is crucial to successfully manage this disease, efficiently allocate resources, and minimize the economic and social burden associated with an undiscriminating approach.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Glycated Hemoglobin / Biomarkers / Diabetes Mellitus, Type 2 / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Diabetes Metab Res Rev Journal subject: Endocrinology / Metabolism Year: 2021 Document Type: Article Affiliation country: Dmrr.3398

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / Glycated Hemoglobin / Biomarkers / Diabetes Mellitus, Type 2 / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Asia Language: English Journal: Diabetes Metab Res Rev Journal subject: Endocrinology / Metabolism Year: 2021 Document Type: Article Affiliation country: Dmrr.3398