Kumar Bharat, Mittal Madhukar, Gopalakrishnan Maya, Garg Mahendra K, Misra Sanjeev
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Endocr Connect. 2021 Jun 8;10(6):589-598. doi: 10.1530/EC-21-0086.
Plasma glucose has been correlated with in-hospital mortality among many diseases including infections. We aimed to study the plasma glucose at the admission of hospitalized patients with COVID-19 at a tertiary care referral hospital at Jodhpur, India and its relation with mortality.
A hospital-based clinical study of plasma glucose of COVID-19 patients conducted from May 15 to June 30, 2020 after ethical approval.
Random blood samples at admission were collected for plasma glucose, interleukin-6 (IL6) and high sensitivity C-reactive protein (hsCRP) after written informed consent was obtained. Plasma glucose was analyzed by the automated analyzer, IL6 by chemiluminescent immunoassay and hsCRP by immune-turbidimetric assay.
A total of 386 patients were studied (female 39.6%); 11.1% had severe disease and 4.1% expired. There were 67 (17.4%) patients with known diabetes mellitus (DM). Patients with a history of DM had three times higher mortality (6/67, 9%) than those without DM (10/309, 3.1%). Patients with moderate and severe disease according to ICMR and WHO grading had higher plasma glucose than those with asymptomatic or mild disease (P < 0.0001). Plasma glucose levels at admission were significantly higher in non-survivors when compared to those who survived (297 ± 117 vs 131 ± 73; P < 0.0001). COVID-19 patients showed increased mortality with incremental plasma glucose levels. The hazard ratio for mortality was 1.128 (95% CI 0.86-14.860), 1.883 (95% CI 0.209-16.970), and 4.005 (95% CI 0.503-32.677) in random plasma glucose group of >100-200, >200-300 and >300 mg/dL, respectively, compared to those with random plasma glucose of <100 mg/dL at admission. Plasma glucose was strongly correlated with hsCRP (P < 0.001) and IL6 (P < 0.0001).
Plasma glucose at admission in hospitalized COVID-19 patients is a strong predictor of mortality.
在包括感染在内的多种疾病中，血糖水平与住院死亡率相关。我们旨在研究印度焦特布尔一家三级医疗转诊医院中新冠病毒疾病（COVID-19）住院患者入院时的血糖水平及其与死亡率的关系。
在获得伦理批准后，于2020年5月15日至6月30日对COVID-19患者的血糖进行了一项基于医院的临床研究。
在获得书面知情同意后，采集入院时的随机血样以检测血糖、白细胞介素-6（IL6）和高敏C反应蛋白（hsCRP）。血糖通过自动分析仪进行分析，IL6通过化学发光免疫分析法进行检测，hsCRP通过免疫比浊法进行检测。
共研究了386例患者（女性占39.6%）；11.1%患有重症疾病，4.1%死亡。有67例（17.4%）患者患有已知的糖尿病（DM）。有糖尿病病史的患者死亡率（6/67，9%）是无糖尿病患者（10/309，3.1%）的三倍。根据印度医学研究理事会（ICMR）和世界卫生组织（WHO）分级，中度和重度疾病患者的血糖高于无症状或轻度疾病患者（P < 0.0001）。与存活患者相比，非存活患者入院时的血糖水平显著更高（297±117 vs 131±73；P < 0.0001）。COVID-19患者的死亡率随血糖水平升高而增加。与入院时随机血糖<100mg/dL的患者相比，随机血糖>100 - 200、>200 - 300和>300mg/dL组的死亡风险比分别为1.128（95%CI 0.86 - 14.860）、1.883（95%CI 0.209 - 16.970）和4.005（95%CI 0.503 - 32.677）。血糖与hsCRP（P < 0.001）和IL6（P < 0.0001）密切相关。
COVID-19住院患者入院时的血糖是死亡率的有力预测指标。
