Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Department of Business Management, Brooklyn College, Brooklyn, NY, USA.
Diabetes Metab Syndr. 2022 Mar;16(3):102439. doi: 10.1016/j.dsx.2022.102439. Epub 2022 Feb 24.
We investigate the impact of blood glucose on mortality and hospital length of stay (HLOS) among COVID-19 patients.
Retrospective study of 456 patients with confirmed COVID-19 and glycemic dysregulation in the New York City area.
We found that impaired glucose adjusted for other organs systems involved (OR:1.87; 95% CI:1.36-2.57, p < 0.001), increased glucose nadir (OR:34.28; 95% CI:3.97-296.05, p < 0.01) and abnormal blood glucose levels at discharge (OR:5.07; 95% CI:2.31-11.14, p < 0.001) were each significantly associated with increased odds for mortality. New or higher from baseline insulin requirement during hospitalization (OR:0.34; 95% CI:0.15-0.78; p < 0.05) was significantly associated with decreased odds for mortality. Increased glucose peak (B = 0.001, SE=<0.001, p < 0.001), new or higher from baseline insulin requirement during hospitalization (B = 0.11, SE = 0.03, p < 0.001), and increased days to dysglycemia (B = 0.15, SE = 0.04, p < 0.001) were each significantly associated with increased HLOS. Increased glucose nadir (B = -0.67, SE = 0.07, p < 0.001), insulin intravenous drip (B = -0.10, SE = 0.05, p < 0.05), and increased proportion days endocrine system involved (B = -0.25, SE = 0.06, p < 0.001) were each significantly associated with decreased HLOS.
Glucose dysregulation adversely affects mortality and HLOS in COVID-19. These data can help clinicians to guide patient treatment and management in COVID-19 patients.
我们研究了血糖对纽约市地区 COVID-19 患者死亡率和住院时间(HLOS)的影响。
对 456 名血糖失调的确诊 COVID-19 患者进行回顾性研究。
我们发现,校正其他器官系统受累的葡萄糖(OR:1.87;95%CI:1.36-2.57,p<0.001)、血糖谷值升高(OR:34.28;95%CI:3.97-296.05,p<0.01)和出院时血糖水平异常(OR:5.07;95%CI:2.31-11.14,p<0.001)均与死亡率增加显著相关。住院期间新的或高于基线的胰岛素需求(OR:0.34;95%CI:0.15-0.78;p<0.05)与死亡率降低显著相关。血糖峰值升高(B=0.001,SE<0.001,p<0.001)、住院期间新的或高于基线的胰岛素需求(B=0.11,SE=0.03,p<0.001)和血糖异常发生天数增加(B=0.15,SE=0.04,p<0.001)均与 HLOS 增加显著相关。血糖谷值降低(B=-0.67,SE=0.07,p<0.001)、静脉滴注胰岛素(B=-0.10,SE=0.05,p<0.05)和内分泌系统受累比例天数增加(B=-0.25,SE=0.06,p<0.001)与 HLOS 降低显著相关。
血糖失调对 COVID-19 患者的死亡率和 HLOS 有不利影响。这些数据可以帮助临床医生指导 COVID-19 患者的治疗和管理。