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High admission blood glucose is an independent risk factor of poor prognosis in COVID-19: A systematic review and dose-response meta-analysis
Preprint
in English
| medRxiv
| ID: ppmedrxiv-20200774
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A scientific journal published article is available and is probably based on this preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT
AimsTo investigate the prognostic value of admission blood glucose (BG) in predicting COVID-19 outcomes, including poor composite outcomes (mortality/severity), mortality, and severity. Materials and methodsEligible studies evaluating the prognostic value of fasting BG (FBG) and random BG (RBG) levels in predicting COVID-19 outcomes were included and assessed for risk of bias with the Quality in Prognosis Studies tool. Random-effects high-vs-low meta-analysis followed by dose-response analysis using generalized least squares model in a two-stage random-effects meta-analysis were conducted. Potential non-linear association was explored using restricted cubic splines and pooled using restricted maximum likelihood model in a multivariate meta-analysis. ResultsThe search yielded 35 studies involving a total of 14,502 patients. We discovered independent association between admission FBG and poor prognosis in COVID-19 patients. Furthermore, we demonstrated non-linear relationship between admission FBG and severity (Pnon-linearity<0.001), where each 1 mmol/L increase augmented the risk of COVID-19 severity by 33% (risk ratio 1.33 [95% CI 1.26-1.40]). Albeit exhibiting similar trends, study scarcity limited the strength of evidence on the independent prognostic value of admission RBG. GRADE assessment yielded high-quality evidence for the association between admission FBG and COVID-19 severity, and moderate-quality evidence for its association with mortality and poor outcomes, while the other assessments yielded very low-to-low quality. ConclusionHigh level of FBG at admission was independently associated with poor prognosis in COVID-19 patients. Further researches to confirm the observed prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and on COVID-19 severity are required.
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Full text:
Available
Collection:
Preprints
Database:
medRxiv
Type of study:
Experimental_studies
/
Prognostic study
/
Rct
/
Review
/
Systematic review
Language:
English
Year:
2020
Document type:
Preprint