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. 2023 Sep 11;15(1):185.
doi: 10.1186/s13098-023-01157-z.

Association between inpatient glycemic variability and COVID-19 mortality: a prospective study

Salma Ali El Chab Parolin  1 , Rebecca Benicio Stocco  2 , Julia do Carmo Kneipp Lopes  2 , Marcos Roberto Curcio Pereira  2 , Milena Massae Yamashita  2 , Maria Eduarda Domareski Goulart  2 , Henrique Demeneck  2 , Marcia Olandoski  2 , Larissa Hermann de Souza Nunes  2 , Victor Keniche Morisawa  2 , Luiz Augusto Fanhani Cracco  2 , Isabela Busto Silva  2 , Jarbas Silva Motta Júnior  2 , Daniela Veit Barreto  2 , Gustavo Lenci Marques  2 , Thyago Proença de Moraes  2 , Cristina Pellegrino Baena  2
Affiliations

Association between inpatient glycemic variability and COVID-19 mortality: a prospective study

Salma Ali El Chab Parolin et al. Diabetol Metab Syndr. .

Abstract

Background: This study aimed to determine the association between glycemic variability (GV) and mortality in hospitalized patients with coronavirus disease 2019 (COVID-19).

Methods: We prospectively analyzed data from inpatients (> 18 years old) with RT-PCR confirmed COVID-19 admitted between March 2020 and July 2021. All patients were hospitalized for more than 48 h and had at least six point-of-care capillary glucose tests obtained three times daily in the pre-prandial period during hospitalization. GV was measured using the glucose standard deviation (SD) and coefficient of variation (CV). ROC curve was adjusted to determine the SD and CV cutoff values associated with mortality (44.7 mg/dL and 27.5%, respectively); values above these were considered indicative of high GV. Logistic regression models were fitted to explore the association between GV and mortality in patients with and without diabetes.

Results: A total of 628 patients were stratified into SD < 44.7 mg/dL (n = 357) versus ≥ 44.7 mg/dL (n = 271) and CV < 27.5% (n = 318) versus ≥ 27.5% (n = 310) groups. After controlling for age, sex, presence of diabetes mellitus (DM) and cardiovascular disease, we found a significant association between high GV and mortality (odds ratio 2.99 [1.88-4.77] for SD and 2.43 [1.54-3.85] for CV; p values < 0.001). The mortality rate was higher with SD ≥ 44.7 mg/dL and CV ≥ 27.5% compared to that with SD < 44.7 mg/dL and CV < 27.5%, regardless of DM (p < 0.001 for all).

Conclusion: High glycemic variability was independently associated with mortality in patients with and without DM, who were hospitalized with COVID-19.

Keywords: COVID-19; Glycemic variability; Mortality, inpatient.

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Conflict of interest statement

I declare that the authors have no competing interests as defined by BMC, or other interests that might be perceived to influence the results and/or discussion reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of the participants' selection process. COVID-19: coronavirus disease-2019
Fig. 2
Fig. 2
Forest plot of the multivariate association of mortality in patients hospitalized with COVID-19, adjusted for glucose standard deviation and coefficient of variation, sex, age, comorbidities, and use of dexamethasone in hospital. SD: glucose standard deviation; CV: glucose coefficient of variation; OR: odds ratio; 95% CI: 95% confidence interval; HTN: hypertension; DM: diabetes mellitus; CVD: cardiovascular disease; CbVD: Cerebrovascular disease; CRI: chronic renal injury; DLP: dyslipidemia; malign: malignancy; OB: obesity; PD: pulmonary disease; Dex: use of dexamethasone in hospital
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References

    1. Rastad H, Karim H, Ejtahed HS, Tajbakhsh R, Noorisepehr M, Babaei M, et al. Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease. Diabetol Metab Syndr. 2020;12(1):1–11. doi: 10.1186/s13098-020-00565-9. - DOI - PMC - PubMed
    1. Mehta PB, Kohn MA, Koliwad SK, Rushakoff RJ. Lack of association between either outpatient or inpatient glycemic control and COVID-19 illness severity or mortality in patients with diabetes. BMJ Open Diabetes Res Care. 2021;9(1):e002203. doi: 10.1136/bmjdrc-2021-002203. - DOI - PMC - PubMed
    1. Bhatti JM, Raza SA, Shahid MO, Akhtar A, Ahmed T, Das B. Association between glycemic control and the outcome in hospitalized patients with COVID-19. Endocrine. 2022;77(2):213–220. doi: 10.1007/s12020-022-03078-9. - DOI - PMC - PubMed
    1. Marshall RJ, Armart P, Hulme KD, Chew KY, Brown AC, Hansbro PM, et al. Glycemic variability in diabetes increases the severity of influenza. MBio. 2020;11(2):1–15. doi: 10.1128/mBio.02841-19. - DOI - PMC - PubMed
    1. Atamna A, Ayada G, Akirov A, Shochat T, Bishara J, Elis A. High blood glucose variability is associated with bacteremia and mortality in patients hospitalized with acute infection. QJM. 2019;112(2):101–106. doi: 10.1093/qjmed/hcy235. - DOI - PubMed

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