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Clinical Trial
. 2020 Nov:169:108437.
doi: 10.1016/j.diabres.2020.108437. Epub 2020 Sep 10.

Fasting blood glucose level is a predictor of mortality in patients with COVID-19 independent of diabetes history

Yuli Cai  1 , Shaobo Shi  2 , Fan Yang  3 , Bo Yi  1 , Xiaolin Chen  1 , Junfeng Li  1 , Zhongyuan Wen  4
Affiliations
Clinical Trial

Fasting blood glucose level is a predictor of mortality in patients with COVID-19 independent of diabetes history

Yuli Cai et al. Diabetes Res Clin Pract. 2020 Nov.

Abstract

Aim: No study elucidated the role of fasting blood glucose (FBG) level in the prognosis of coronavirus disease 2019 (COVID-19).

Methods: This cohort study was conducted in a single center at Renmin Hospital of Wuhan University, Wuhan, China. Clinical laboratory, and treatment data of inpatients with laboratory-confirmed COVID-19 were collected and analyzed. Outcomes of patients with and without pre-existing diabetes were compared. The associations of diabetes history and/or FBG levels with mortality were analyzed. Multivariate cox regression analysis on the risk factors associated with mortality in patients with COVID-19 was performed.

Results: A total of 941 hospitalized patients with COVID-19 were enrolled in the study. There was a positive relationship between pre-existing diabetes and the mortality of patients who developed COVID-19 (21 of 123 [17.1%] vs 76 of 818 [9.3%]; P = 0.012). FBG ≥7.0 mmol/L was an independent risk factor for the mortality of COVID-19 regardless of the presence or not of a history of diabetes (hazard ratio, 2.20 [95% CI, 1.21-4.03]; P = 0.010).

Conclusions: We firstly showed FBG ≥7.0 mmol/L predicted worse outcome in hospitalized patients with COVID-19 independent of diabetes history. Our findings indicated screening FBG level is an effective method to evaluate the prognosis of patients with COVID-19.

Keywords: Coronavirus disease 2019; Diabetes; Fasting blood glucose; Mortality.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival curves of survival probability in hospitalized patients with COVID-19. A. Mortality was higher in patients with diabetes. B. Mortality was significantly higher in patients with FBG ≥ 7.0 mmol/l. C. Among diabetes subjects, mortality was higher in patients with FBG ≥ 7.0 mmol/L, there was no statistical difference after log-rank test. D. Among non-diabetes subjects, the mortality was significantly higher in patients with FBG ≥ 7.0 mmol/L. FBG, fasting blood glucose.
Fig. 2
Fig. 2
Contour plot of survival probability in hospitalized patients with COVID-19. A. Mortality was higher in patients with senior age. B. In diabetes group, mortality was higher in patients with hyperglycemia. C. In non-diabetes group, mortality was higher in patients with hyperglycemia and senior age. FBG, fasting blood glucose.
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