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. 2021 Mar 30:12:640529.
doi: 10.3389/fendo.2021.640529. eCollection 2021.

Association Between Longitudinal Change in Abnormal Fasting Blood Glucose Levels and Outcome of COVID-19 Patients Without Previous Diagnosis of Diabetes

Siwei Song  1 , Shujing Zhang  1 , Zhihui Wang  2 , Sufei Wang  1 , Yanling Ma  1 , Pei Ma  1 , Huilin Luo  3 , Mengyuan Wang  4 , Yang Jin  1
Affiliations

Association Between Longitudinal Change in Abnormal Fasting Blood Glucose Levels and Outcome of COVID-19 Patients Without Previous Diagnosis of Diabetes

Siwei Song et al. Front Endocrinol (Lausanne). .

Abstract

This retrospective study examined changes in fasting blood glucose (FBG) levels during hospitalization and their effect on risk of death for Coronavirus disease 2019 (COVID-19) patients without previously diagnosed diabetes. A model with low- and high-stable pattern trajectories was established based on a longitudinal change in FBG levels. We analyzed FBG trajectory-associated clinical features and risk factors for death due to COVID-19. Of the 230 enrolled patients, 44 died and 87.83% had a low-stable pattern (average FBG range: 6.63-7.54 mmol/L), and 12.17% had a high-stable pattern (average FBG range: 12.59-14.02 mmol/L). There were statistical differences in laboratory findings and case fatality between the two FBG patterns. Multivariable logistic regression analysis showed that increased neutrophil count (odds ratio [OR], 25.43; 95% confidence interval [CI]: 2.07, 313.03), elevated direct bilirubin (OR, 5.80; 95%CI: 1.72, 19.58), elevated creatinine (OR, 26.69; 95% CI: 5.82, 122.29), lymphopenia (OR, 8.07; 95% CI: 2.70, 24.14), and high-stable FBG pattern (OR, 8.79; 95% CI: 2.39, 32.29) were independent risk factors for higher case fatality in patients with COVID-19 and hyperglycemia but no history of diabetes. FBG trajectories were significantly associated with death risk in patients with COVID-19 and no diabetes.

Keywords: COVID-19; SARS-CoV-2; fasting blood glucose trajectory; glycemic control; longitudinal change.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient selection.
Figure 2
Figure 2
Fasting blood glucose trajectories with low-stable and high-stable patterns based on longitudinal change in fasting blood glucose.
Figure 3
Figure 3
Survival analysis between low-stable and high-stable pattern trajectories.
See this image and copyright information in PMC

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