Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without pr
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ARTICLE
Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study Sufei Wang 1 & Pei Ma 1 & Shujing Zhang 1 & Siwei Song 1 & Zhihui Wang 2 & Yanling Ma 1 & Juanjuan Xu 1 & Feng Wu 1 & Limin Duan 1 & Zhengrong Yin 1 & Huilin Luo 3 & Nian Xiong 4 & Man Xu 5 & Tianshu Zeng 6 & Yang Jin 1 Received: 17 April 2020 / Accepted: 10 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aims/hypothesis Hyperglycaemia is associated with an elevated risk of mortality in community-acquired pneumonia, stroke, acute myocardial infarction, trauma and surgery, among other conditions. In this study, we examined the relationship between fasting blood glucose (FBG) and 28-day mortality in coronavirus disease 2019 (COVID-19) patients not previously diagnosed as having diabetes. Methods We conducted a retrospective study involving all consecutive COVID-19 patients with a definitive 28-day outcome and FBG measurement at admission from 24 January 2020 to 10 February 2020 in two hospitals based in Wuhan, China. Demographic and clinical data, 28-day outcomes, in-hospital complications and CRB-65 scores of COVID-19 patients in the two hospitals were analysed. CRB-65 is an effective measure for assessing the severity of pneumonia and is based on four indicators, i.e. confusion, respiratory rate (>30/min), systolic blood pressure (≤90 mmHg) or diastolic blood pressure (≤60 mmHg), and age (≥65 years). Results Six hundred and five COVID-19 patients were enrolled, including 114 who died in hospital. Multivariable Cox regression analysis showed that age (HR 1.02 [95% CI 1.00, 1.04]), male sex (HR 1.75 [95% CI 1.17, 2.60]), CRB-65 score 1–2 (HR 2.68 [95% CI 1.56, 4.59]), CRB-65 score 3–4 (HR 5.25 [95% CI 2.05, 13.43]) and FBG ≥7.0 mmol/l (HR 2.30 [95% CI 1.49, 3.55]) were independent predictors for 28-day mortality. The OR for 28-day in-hospital complications in those with FBG ≥7.0 mmol/l and 6.1–6.9 mmol/l vs 10 mmol/l twice within any 24 h period) were associated with an increased length of hospital stay and higher mortality due to COVID-19 [13]. Furthermore, wellcontrolled blood glucose (glycaemic variability within 3.9– 10.0 mmol/l) was reportedly associated with markedly lower mortality compared with individuals with poorly controlled blood glucose (upper limit of glycaemic variability exceeding 10.0 mmol/l) in patients with pre-existing type 2 diabetes during hospitalisation for COVID-19 [14]. However, direct correlation between fasting blood glucose (FBG) level at admission and clinical outcomes of COVID-19 patients without diagnosed diabetes has not been well established. Therefore, in this study, we examined the association between
Diabetologia
FBG on admission and the 28-day mortality of COVID-19 patients without previously diagnosed diabetes in two hospitals.
Methods Study design and participants We conducted a retrospective study of COVID-19 patients admitted to Wuhan Union West Ho
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