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. 2021 Jan;93(1):409-415.
doi: 10.1002/jmv.26227. Epub 2020 Jul 17.

Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID-19

Stephen M Smith  1 , Avinash Boppana  1 , Julie A Traupman  1 , Enrique Unson  1 , Daniel A Maddock  1 , Kathy Chao  1 , David P Dobesh  2 , Adam Brufsky  3 , Ruth I Connor  4
Affiliations

Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID-19

Stephen M Smith et al. J Med Virol. 2021 Jan.

Abstract

Identification of risk factors of severe coronavirus disease 2019 (COVID-19) is critical for improving therapies and understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis. We analyzed 184 patients hospitalized for COVID-19 in Livingston, New Jersey for clinical characteristics associated with severe disease. The majority of patients with COVID-19 had diabetes mellitus (DM) (62.0%), Pre-DM (23.9%) with elevated fasting blood glucose (FBG), or a body mass index >30 with normal hemoglobin A1c (HbA1C) (4.3%). SARS-CoV-2 infection was associated with new and persistent hyperglycemia in 29 patients, including several with normal HbA1C levels. Forty-four patients required intubation, which occurred significantly more often in patients with DM as compared with non-diabetics. Severe COVID-19 occurs in the presence of impaired glucose metabolism in patients, including those with DM, preDM, and obesity. COVID-19 is associated with elevated FBG and several patients presented with new onset DM or in DKA. The association of dysregulated glucose metabolism and severe COVID-19 suggests that SARS-CoV-2 pathogenesis involves a novel interplay with glucose metabolism. Exploration of pathways by which SARS-CoV-2 interacts glucose metabolism is critical for understanding disease pathogenesis and developing therapies.

Keywords: COVID-19; SARS-CoV-2; diabetes mellitus; glucose metabolism disorder; hyperglycemia; obesity.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

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