AI Article Synopsis
- The study examines the impact of glycemic control on COVID-19 outcomes in diabetic patients, focusing on factors like hyperglycemia, inflammation, and clinical history.
- It involved a retrospective analysis of 291 diabetic patients, finding that high blood glucose levels at admission and poor kidney function significantly increased the risk of mortality and longer hospital stays.
- Interestingly, while hyperglycemia directly correlated with higher mortality, certain inflammatory markers showed indirect effects, and a higher basophil count appeared to be protective against mortality.
Article Abstract
Introduction: The role of glycemic control, both prior and during hospitalization, on mortality from COVID-19 in diabetic patients is debated. Furthermore, it is not clear whether hyperglycemia has a direct effect or requires inflammatory mechanisms.
Objective: To identify predictors of clinical outcomes (in-hospital mortality, length of hospitalization, respiratory failure, need for intensive care), considering hyperglycemia, inflammation markers and clinical history.
Methods: Retrospective observational study of 291 diabetic patients hospitalized with COVID-19 in the Spedali Civili di Brescia from February 1th 2020 to March 31th 2021, with also outpatient electronic records. Glucose, inflammatory parameters, creatinine were collected within 24 h after admission to the hospital. A causal mediation analysis allowed the estimation of the direct and indirect effects of hyperglycemia on mortality.
Results: Glucose at admission ≥ 165 mg/dL and reduced renal function were associated with an increased risk of in-hospital mortality and length of hospitalization (all p < 0.001), while an increase in inflammatory parameters was significantly associated with an increased risk of all outcomes. High basophil count was associated with reduced mortality (p < 0.001). Hyperglycemia had a direct effect on mortality (p < 0.001); the indirect, through inflammatory markers, was significant only for absolute neutrophil count, C-Reactive protein and procalcitonin (p = 0.007, p = 0.029, p = 0.042). Patients with microvascular complications and with chronic kidney disease showed higher mortality (p = 0.03, p = 0.01).
Conclusions: Hyperglycemia at admission, renal function and inflammatory parameters were found to be predictors of in-hospital mortality, while an increased basophil count was protective. Hyperglycemia had a direct effect on mortality, the indirect effect was only through few markers and markedly lower than the direct one.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9652602 | PMC |
| http://dx.doi.org/10.1186/s13098-022-00941-7 | DOI Listing |
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