Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study

Clara L. Clausen; Christian Leo-Hansen; Daniel Faurholt-Jepsen; Rikke Krogh-Madsen; Christian Ritz; Ole Kirk; Henrik L. Jørgensen; Thomas Benfield; Thomas P. Almdal; Ole Snorgaard

doi:10.1016/j.diabres.2022.109880

Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study

Clara L. Clausen^*, Christian Leo-Hansen, Daniel Faurholt-Jepsen, Rikke Krogh-Madsen, Christian Ritz, Ole Kirk, Henrik L. Jørgensen, Thomas Benfield, Thomas P. Almdal, Ole Snorgaard

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

4 Citationer (Scopus)

Abstract

Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality.

Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA_1c measurement 60 days prior to or within 7 days after admission. We studied the association between diabetes status, the glycemic gap (difference between admission and habitual status), admission plasma-glucose, and mortality using Cox proportional hazards regression.

Results: Of 674 patients included, 114 (17%) had normal glucose level, 287 (43%) had pre-diabetes, 74 (11%) had new-onset, and 199 (30%) had diagnosed diabetes. No association between diabetes status, plasma-glucose at admission, and mortality was found. Compared to the 2nd quartile (reference) of glycemic-gap, those with the highest glycemic gap had increased mortality (3rd (HR 2.38 [1.29–4.38], p = 0.005) and 4th quartile (HR 2.48 [1.37–4.52], p = 0.002).

Conclusion: Abnormal glucose metabolism was highly prevalent among patients hospitalized with COVID-19. Diabetes status per se or admission plasma-glucose was not associated with a poorer outcome. However, a high glycemic gap was associated with increased risk of mortality, suggesting that, irrespective of diabetes status, glycemic stress serves as an important prognostic marker for mortality.

Originalsprog	Engelsk
Artikelnummer	109880
Tidsskrift	Diabetes Research and Clinical Practice
Vol/bind	187
Antal sider	8
ISSN	0168-8227
DOI	https://doi.org/10.1016/j.diabres.2022.109880
Status	Udgivet - 2022

Bibliografisk note

Funding Information:
CLC, CLH, DFJ, RKM, CR, OK, OS report no conflict of interest. TPA holds stocks in Novo Nordisk A/S. TB reports grants from Novo Nordisk Foundation, grants from Simonsen Foundation, grants and personal fees from GSK, grants and personal fees from Pfizer, personal fees from Boehringer Ingelheim, grants and personal fees from Gilead, personal fees from MSD, personal fees from Astra Zeneca, grants from Lundbeck Foundation, grants from Kai Hansen Foundation, personal fees from Pentabase ApS, grants from Erik and Susanna Olesen’s Charitable Fund, outside the submitted work.

Publisher Copyright:
© 2022

Adgang til dokumentet

10.1016/j.diabres.2022.109880

https://europepmc.org/articles/pmc9055392?pdf=renderLicens: Andet

Citationsformater

Clausen, C. L., Leo-Hansen, C., Faurholt-Jepsen, D., Krogh-Madsen, R., Ritz, C., Kirk, O., Jørgensen, H. L., Benfield, T., Almdal, T. P., & Snorgaard, O. (2022). Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study. Diabetes Research and Clinical Practice, 187, [109880]. https://doi.org/10.1016/j.diabres.2022.109880

Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study. / Clausen, Clara L.; Leo-Hansen, Christian; Faurholt-Jepsen, Daniel; Krogh-Madsen, Rikke; Ritz, Christian; Kirk, Ole ; Jørgensen, Henrik L.; Benfield, Thomas ; Almdal, Thomas P.; Snorgaard, Ole.

I: Diabetes Research and Clinical Practice, Bind 187, 109880, 2022.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Clausen, Clara L. ; Leo-Hansen, Christian ; Faurholt-Jepsen, Daniel ; Krogh-Madsen, Rikke ; Ritz, Christian ; Kirk, Ole ; Jørgensen, Henrik L. ; Benfield, Thomas ; Almdal, Thomas P. ; Snorgaard, Ole. / Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study. I: Diabetes Research and Clinical Practice. 2022 ; Bind 187.

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title = "Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study",

abstract = "Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality. Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA1c measurement 60 days prior to or within 7 days after admission. We studied the association between diabetes status, the glycemic gap (difference between admission and habitual status), admission plasma-glucose, and mortality using Cox proportional hazards regression. Results: Of 674 patients included, 114 (17%) had normal glucose level, 287 (43%) had pre-diabetes, 74 (11%) had new-onset, and 199 (30%) had diagnosed diabetes. No association between diabetes status, plasma-glucose at admission, and mortality was found. Compared to the 2nd quartile (reference) of glycemic-gap, those with the highest glycemic gap had increased mortality (3rd (HR 2.38 [1.29–4.38], p = 0.005) and 4th quartile (HR 2.48 [1.37–4.52], p = 0.002). Conclusion: Abnormal glucose metabolism was highly prevalent among patients hospitalized with COVID-19. Diabetes status per se or admission plasma-glucose was not associated with a poorer outcome. However, a high glycemic gap was associated with increased risk of mortality, suggesting that, irrespective of diabetes status, glycemic stress serves as an important prognostic marker for mortality.",

keywords = "COVID-19, Glucometabolic changes, Glycemic gap, Hospitalization, Mortality",

author = "Clausen, {Clara L.} and Christian Leo-Hansen and Daniel Faurholt-Jepsen and Rikke Krogh-Madsen and Christian Ritz and Ole Kirk and J{\o}rgensen, {Henrik L.} and Thomas Benfield and Almdal, {Thomas P.} and Ole Snorgaard",

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T1 - Glucometabolic changes influence hospitalization and outcome in patients with COVID-19: An observational cohort study

AU - Clausen, Clara L.

AU - Leo-Hansen, Christian

AU - Faurholt-Jepsen, Daniel

AU - Krogh-Madsen, Rikke

AU - Ritz, Christian

AU - Kirk, Ole

AU - Jørgensen, Henrik L.

AU - Benfield, Thomas

AU - Almdal, Thomas P.

AU - Snorgaard, Ole

PY - 2022

Y1 - 2022

N2 - Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality. Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA1c measurement 60 days prior to or within 7 days after admission. We studied the association between diabetes status, the glycemic gap (difference between admission and habitual status), admission plasma-glucose, and mortality using Cox proportional hazards regression. Results: Of 674 patients included, 114 (17%) had normal glucose level, 287 (43%) had pre-diabetes, 74 (11%) had new-onset, and 199 (30%) had diagnosed diabetes. No association between diabetes status, plasma-glucose at admission, and mortality was found. Compared to the 2nd quartile (reference) of glycemic-gap, those with the highest glycemic gap had increased mortality (3rd (HR 2.38 [1.29–4.38], p = 0.005) and 4th quartile (HR 2.48 [1.37–4.52], p = 0.002). Conclusion: Abnormal glucose metabolism was highly prevalent among patients hospitalized with COVID-19. Diabetes status per se or admission plasma-glucose was not associated with a poorer outcome. However, a high glycemic gap was associated with increased risk of mortality, suggesting that, irrespective of diabetes status, glycemic stress serves as an important prognostic marker for mortality.

AB - Aims: The aim was to report the prevalence of diabetes status in patients hospitalized with COVID-19 and assess the association between the glucometabolic status at admission and 90-day mortality. Methods: Consecutive patients hospitalized with COVID-19 were included in the study. All participants included had an HbA1c measurement 60 days prior to or within 7 days after admission. We studied the association between diabetes status, the glycemic gap (difference between admission and habitual status), admission plasma-glucose, and mortality using Cox proportional hazards regression. Results: Of 674 patients included, 114 (17%) had normal glucose level, 287 (43%) had pre-diabetes, 74 (11%) had new-onset, and 199 (30%) had diagnosed diabetes. No association between diabetes status, plasma-glucose at admission, and mortality was found. Compared to the 2nd quartile (reference) of glycemic-gap, those with the highest glycemic gap had increased mortality (3rd (HR 2.38 [1.29–4.38], p = 0.005) and 4th quartile (HR 2.48 [1.37–4.52], p = 0.002). Conclusion: Abnormal glucose metabolism was highly prevalent among patients hospitalized with COVID-19. Diabetes status per se or admission plasma-glucose was not associated with a poorer outcome. However, a high glycemic gap was associated with increased risk of mortality, suggesting that, irrespective of diabetes status, glycemic stress serves as an important prognostic marker for mortality.

KW - COVID-19

KW - Glucometabolic changes

KW - Glycemic gap

KW - Hospitalization

KW - Mortality

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DO - 10.1016/j.diabres.2022.109880

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JF - Diabetes Research and Clinical Practice

SN - 0168-8227

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