Serviço de Endocrinologia, Hospital de Braga, Braga, Portugal,
Serviço de Endocrinologia, Hospital de Braga, Braga, Portugal.
Arch Endocrinol Metab. 2023 Jun 19;67(6):e000649. doi: 10.20945/2359-3997000000649.
Hyperglycemia has been suggested as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). The aim of our work was to evaluate the association between blood glucose levels at admission (BGA) and disease outcomes in hospitalized COVID-19 patients.
Retrospective study including all adult COVID-19 patients admitted to a Portuguese hospital from March to August 2020 with BGA measurement. Subjects were categorized into two groups: BGA < 140 mg/dL and ≥ 140 mg/dL. Statistical analysis was performed using SPSSv26 (significance defined as < 0.05).
We included 202 patients: median age 74 (60-86) years; 43.1% female; 31.2% with diabetes. The median BGA was 130.5 (108-158) mg/dL. When compared to normoglycemic, patients with BGA ≥ 140 mg/dL were older ( = 0.013), more vaccinated for ( = 0.025) and had more comorbidities (hypertension, heart failure and peripheral arterial disease, < 0.05). The last group presented higher leucocyte and neutrophile count, higher procalcitonin and prothrombin time, and lower lymphocyte count. Concerning prognosis, BGA ≥ 140 mg/dL was associated with higher rates of mechanical ventilation requirement and intensive care unit admission ( < 0.001), shock ( = 0.011), in-hospital mortality ( = 0.022) and 30-day mortality ( = 0.037). Considering only non-diabetic patients (n = 139), those with hyperglycemia presented higher rates of severity indicators (polypnea, SatO ≤ 93% and PaO/FiO ≤ 300) and an association with poor outcomes was also found, namely mechanical ventilation requirement and in-hospital/30-day mortality ( < 0.05).
Hyperglycemia at admission was associated with poor outcomes in COVID-19 patients, even in those without known pre-existing diabetes. Glycemic testing should be recommended for all COVID-19 patients.
高血糖被认为是 2019 年冠状病毒病（COVID-19）不良结局的危险因素。我们的工作目的是评估住院 COVID-19 患者入院时血糖水平（BGA）与疾病结局的关系。
回顾性研究纳入 2020 年 3 月至 8 月期间葡萄牙一家医院收治的所有成年 COVID-19 患者，测量 BGA。将受试者分为两组：BGA<140mg/dL 和 BGA≥140mg/dL。使用 SPSSv26 进行统计分析（显著性定义为<0.05）。
我们纳入了 202 名患者：中位年龄 74（60-86）岁；43.1%为女性；31.2%患有糖尿病。中位 BGA 为 130.5（108-158）mg/dL。与血糖正常的患者相比，BGA≥140mg/dL 的患者年龄更大（=0.013），接种疫苗的比例更高（=0.025），合并症更多（高血压、心力衰竭和外周动脉疾病，<0.05）。最后一组白细胞和中性粒细胞计数更高，降钙素原和凝血酶原时间更高，淋巴细胞计数更低。就预后而言，BGA≥140mg/dL 与更高的机械通气需求和重症监护病房入住率（<0.001）、休克（=0.011）、住院死亡率（=0.022）和 30 天死亡率（=0.037）相关。仅考虑非糖尿病患者（n=139），高血糖患者的严重程度指标（呼吸急促、SatO≤93%和 PaO/FiO≤300）更高，与不良结局相关，即机械通气需求和住院/30 天死亡率（<0.05）。
入院时的高血糖与 COVID-19 患者的不良结局相关，即使在无已知糖尿病的患者中也是如此。应建议所有 COVID-19 患者进行血糖检测。
