Endocrine Abstracts

COVID-19 infection is associated with worse outcomes in patients with hyperglycemia. Our study evaluates the relationship between diabetes control before and during hospitalization, the severity of SARS-CoV-2 infection, and mortality in patients with type 2 diabetes

Methods: The 857 patients were divided into four groups according to blood glucose control. The first group included 365 patients with an average blood glucose ≤ 140 mg/dl, the second group included 201 patients with an average blood glucose of -140-180 mg/dl, the third group included 198 patients with an average blood glucose of 180-250 mg/dl, and 93 patients in the fourth group had an average blood glucose >250 mg/dl. In all subjects, we assessed preadmission diabetes treatment and prior diagnoses of major comorbidities (atherosclerotic cardiovascular disease, congestive heart failure, chronic renal disease, chronic pulmonary diseases, and dementia). Glucose control during hospitalization, diabetes medications before and during hospitalization, renal function, and glucocorticoid treatment were retrieved from electronic health data. COVID-19 death at 30 days was assessed in the four groups.

Results: Among patients with poor preadmission glucose control (Hba1c>9%), one-third had average blood glucose >250 mg/dl during hospitalization and only 8% had adequate blood glucose control. The overall 30-day mortality rate was 19% (192 patients out of 857) and was highest among patients with uncontrolled blood glucose during hospitalization compared to well-controlled blood glucose (32% vs. 14%). Significant predictors of mortality were the severity of COVID-19, acute renal failure, and a diagnosis of congestive heart failure before hospitalization

Table 4. Logistic regression of variables predicted 30 days mortality.

Table 4. Ordinal logistic regression of variables related to glucose control during hospitalization.

Conclusion: In patients with type 2 diabetes hospitalized with COVID-19, poor long-term glycemic control is associated with the level of hyperglycemia during hospitalization, and the COVID-19 severity.