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. 2021 Aug 28;13(9):3010.
doi: 10.3390/nu13093010.

Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition

Francisco Arrieta  1   2 , Victoria Martinez-Vaello  1 , Nuria Bengoa  1 , Marta Rosillo  3 , Angélica de Pablo  4 , Cristina Voguel  4 , Rosario Pintor  5 , Amaya Belanger-Quintana  6 , Raquel Mateo-Lobo  1 , Angel Candela  4 , José I Botella-Carretero  1   2
Affiliations

Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition

Francisco Arrieta et al. Nutrients. .

Abstract

We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer (p = 0.004), and needed more frequently insulin infusion therapy (p = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy (p = 0.001) and glucose delivered through artificial nutrition (p = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 ± 17 vs. 11 ± 13 days, p = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU (r = -0.476, p = 0.001) and at days 2 (r = -0.409, p = 0.007) and 3 (r = -0.351, p = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.

Keywords: COVID-19; enteral nutrition; hyperglycemia; osteocalcin; parenteral nutrition.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Correlations of circulating osteocalcin with glycemia and HbA1c.
Figure 2
Figure 2
Correlations of energy and glucose delivered through artificial nutrition with glycemia.
Figure 3
Figure 3
Correlations of serum inflammatory markers with glycemia.
See this image and copyright information in PMC

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