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. 2020 Oct;22(10):1897-1906.
doi: 10.1111/dom.14099. Epub 2020 Jun 30.

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID-19

Huiqing Li  1   2 , Shenghua Tian  1   2 , Ting Chen  1   2 , Zhenhai Cui  1   2 , Ningjie Shi  1   2 , Xueyu Zhong  1   2 , Kangli Qiu  1   2 , Jiaoyue Zhang  1   2 , Tianshu Zeng  1   2 , Lulu Chen  1   2 , Juan Zheng  1   2
Affiliations

Newly diagnosed diabetes is associated with a higher risk of mortality than known diabetes in hospitalized patients with COVID-19

Huiqing Li et al. Diabetes Obes Metab. 2020 Oct.

Abstract

Aim: To evaluate the association between different degrees of hyperglycaemia and the risk of all-cause mortality among hospitalized patients with COVID-19.

Materials and methods: In a retrospective study conducted from 22 January to 17 March 2020, 453 patients were admitted to Union Hospital in Wuhan, China, with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Patients were classified into four categories: normal glucose, hyperglycaemia (fasting glucose 5.6-6.9 mmol/L and/or HbA1c 5.7%-6.4%), newly diagnosed diabetes (fasting glucose ≥7 mmol/L and/or HbA1c ≥6.5%) and known diabetes. The major outcomes included in-hospital mortality, intensive care unit (ICU) admission and invasive mechanical ventilation (IMV).

Results: Patients with newly diagnosed diabetes constituted the highest percentage to be admitted to the ICU (11.7%) and require IMV (11.7%), followed by patients with known diabetes (4.1%; 9.2%) and patients with hyperglycaemia (6.2%; 4.7%), compared with patients with normal glucose (1.5%; 2.3%), respectively. The multivariable-adjusted hazard ratios of mortality among COVID-19 patients with normal glucose, hyperglycaemia, newly diagnosed diabetes and known diabetes were 1.00, 3.29 (95% confidence interval [CI] 0.65-16.6), 9.42 (95% CI 2.18-40.7) and 4.63 (95% CI 1.02-21.0), respectively.

Conclusion: We showed that COVID-19 patients with newly diagnosed diabetes had the highest risk of all-cause mortality compared with COVID-19 patients with known diabetes, hyperglycaemia and normal glucose. Patients with COVID-19 need to be kept under surveillance for blood glucose screening.

Keywords: diabetes complications; hypoglycaemia.

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Conflict of interest statement

All the authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
The cumulative hazard of mortality according to different glucose categories among patients with COVID‐19. Adjusted for age, sex, smoking, systolic blood pressure and total cholesterol
FIGURE 2
FIGURE 2
Hazard ratios for all‐cause mortality based on different levels of fasting plasma glucose among COVID‐19 patients without known diabetes. Adjusted for age, sex, smoking, systolic blood pressure and total cholesterol
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