Department of Endocrinology and Metabolism, HealthWorld Hospitals, Gandhi More, Durgapur, India.
Department of Endocrinology and Metabolism, HealthWorld Hospitals, Gandhi More, Durgapur, India.
Diabetes Res Clin Pract. 2022 Aug;190:109974. doi: 10.1016/j.diabres.2022.109974. Epub 2022 Jul 7.
To compare admission-blood-glucose (ABG) or stress-hyperglycemia-ratio (SHR) performs better in predicting mortality and worse outcomes in COVID-19 patients with (DM) and without known Type 2 Diabetes Mellitus (UDM).
ABG and SHR were tested for 451 patients with moderate-severe COVID-19 infection [DM = 216,47.9%; pre-diabetes = 48,10.6%, UDM = 187,41.4%],who were followed-up to look for in-hospital-mortality (primary outcome) and secondary outcomes (ICU stay or mechanical ventilation, hospital-acquired-sepsis and multiple organ dysfunction syndrome [MODS]). Those with and without SHR ≥ 1.14 were compared; logistic regression was done to identify predictors of outcomes, with subgroup analysis based on pre-existing DM status and COVID-19 severity.
Those who died (n = 131) or developed ≥ 1 secondary outcomes (n = 218) had higher prevalence of SHR ≥ 1.14, ABG ≥ 180 mg/dl and higher median SHR (p < 0.01). Those with SHR ≥ 1.14 had higher mortality (53.7%), higher incidence of ≥ 1 secondary outcomes (71.3%) irrespective of pre-existing diabetes status. SHR ≥ 1.14, but not ABG ≥ 180 was an independent predictor of mortality in the whole group (OR: 7.81,4.07-14.98), as also the DM (OR:10.51,4.34-25.45) and UDM (5.40 (1.57-18.55) subgroups. SHR ≥ 1.14 [OR: 4.41 (2.49-7.84)] but not ABG ≥ 180 could independently predict secondary outcomes AUROC of SHR in predicting mortality was significantly higher than ABG in all subgroups.
SHR better predicts mortality and adverse outcomes than ABG in patients with COVID-19, irrespective of pre-existing chronic glycemic status.
比较入院血糖（ABG）或应激性高血糖比值（SHR）在预测 COVID-19 合并（DM）和不伴已知 2 型糖尿病（UDM）的患者死亡率和不良结局方面的表现。
对 451 例中重度 COVID-19 感染患者进行 ABG 和 SHR 检测[DM=216，47.9%；糖尿病前期=48，10.6%，UDM=187，41.4%]，随访观察院内死亡率（主要结局）和次要结局（ICU 入住或机械通气、医院获得性败血症和多器官功能障碍综合征[MODS]）。比较 SHR≥1.14 和 SHR<1.14 的患者；采用 logistic 回归分析确定结局的预测因素，并根据预先存在的 DM 状态和 COVID-19 严重程度进行亚组分析。
死亡（n=131）或出现≥1 项次要结局（n=218）的患者，SHR≥1.14、ABG≥180mg/dl 和中位数 SHR 更高（p<0.01）。SHR≥1.14 的患者死亡率（53.7%）和≥1 项次要结局发生率（71.3%）更高，与预先存在的糖尿病状态无关。SHR≥1.14 而不是 ABG≥180 是全组死亡率的独立预测因素（OR：7.81，4.07-14.98），DM（OR：10.51，4.34-25.45）和 UDM（OR：5.40，1.57-18.55）亚组也是如此。SHR≥1.14[OR：4.41（2.49-7.84）]而不是 ABG≥180 可独立预测次要结局。SHR 预测死亡率的 AUROC 明显高于 ABG 预测死亡率，在所有亚组中均如此。
SHR 可预测 COVID-19 患者的死亡率和不良结局，优于 ABG，而与预先存在的慢性血糖状态无关。
