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Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019.

Abstract

Background:

Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19.

Methods:

In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models.

Results:

The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities.

Conclusion:

IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.

Authors+Show Affiliations

Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Endocrinology, The Fifth Hospital of Wuhan, Wuhan, China.Department of Endocrinology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.Department of Endocrinology, General Hospital of the Yangtze River Shipping, Wuhan, China.Department of Endocrinology, Hankou Hospital of Wuhan City, Wuhan, China.Department of Endocrinology, Red Cross Hospital of Wuhan City, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Endocrinology, The Fifth Hospital of Wuhan, Wuhan, China.Department of Endocrinology, Hankou Hospital of Wuhan City, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Clinical and Research Centre of Thrombosis and Haemostasis, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32754119

Citation

Zhang, Jiaoyue, et al. "Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019." Frontiers in Endocrinology, vol. 11, 2020, p. 525.
Zhang J, Kong W, Xia P, et al. Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019. Front Endocrinol (Lausanne). 2020;11:525.
Zhang, J., Kong, W., Xia, P., Xu, Y., Li, L., Li, Q., Yang, L., Wei, Q., Wang, H., Li, H., Zheng, J., Sun, H., Xia, W., Liu, G., Zhong, X., Qiu, K., Li, Y., Wang, H., Wang, Y., ... Zeng, T. (2020). Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019. Frontiers in Endocrinology, 11, 525. https://doi.org/10.3389/fendo.2020.00525
Zhang J, et al. Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019. Front Endocrinol (Lausanne). 2020;11:525. PubMed PMID: 32754119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired Fasting Glucose and Diabetes Are Related to Higher Risks of Complications and Mortality Among Patients With Coronavirus Disease 2019. AU - Zhang,Jiaoyue, AU - Kong,Wen, AU - Xia,Pengfei, AU - Xu,Ying, AU - Li,Li, AU - Li,Qin, AU - Yang,Li, AU - Wei,Qi, AU - Wang,Hanyu, AU - Li,Huiqing, AU - Zheng,Juan, AU - Sun,Hui, AU - Xia,Wenfang, AU - Liu,Geng, AU - Zhong,Xueyu, AU - Qiu,Kangli, AU - Li,Yan, AU - Wang,Han, AU - Wang,Yuxiu, AU - Song,Xiaoli, AU - Liu,Hua, AU - Xiong,Si, AU - Liu,Yumei, AU - Cui,Zhenhai, AU - Hu,Yu, AU - Chen,Lulu, AU - Pan,An, AU - Zeng,Tianshu, Y1 - 2020/07/10/ PY - 2020/05/27/received PY - 2020/06/29/accepted PY - 2020/8/6/entrez PY - 2020/8/6/pubmed PY - 2020/8/22/medline KW - COVID-19 KW - cohort study KW - coronavirus KW - diabetes KW - hyperglycemia KW - impaired fasting glucose KW - severe acute respiratory coronavirus 2 (SARS-CoV-2) SP - 525 EP - 525 JF - Frontiers in endocrinology JO - Front Endocrinol (Lausanne) VL - 11 N2 - Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results: The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19. SN - 1664-2392 UR - https://www.unboundmedicine.com/medline/citation/32754119/Impaired_Fasting_Glucose_and_Diabetes_Are_Related_to_Higher_Risks_of_Complications_and_Mortality_Among_Patients_With_Coronavirus_Disease_2019_ L2 - https://doi.org/10.3389/fendo.2020.00525 DB - PRIME DP - Unbound Medicine ER -