The impact of impaired insulin regulation on severity of SARS-CoV-2 infection: a 2-year retrospective single-center analysis.

Autor:	Phan AT; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Ucar A; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Malkoc A; General Surgery, Arrowhead Regional Medical Center., Nagori E; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Qadir A; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Khosravi C; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Tseng A; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Nguyễ Ên JPT; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Modi AP; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Deshpande O; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Lay J; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Ku A; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Dong F; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Ogunyemi D; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA., Arabian S; Departments of Internal Medicine.; Critical Care Medicine.; California University of Science and Medicine, Colton, CA.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2023 Sep 15; Vol. 85 (11), pp. 5350-5354. Date of Electronic Publication: 2023 Sep 15 (Print Publication: 2023).
DOI:	10.1097/MS9.0000000000001306
Abstrakt:	Background: The COVID-19 pandemic has caused an international healthcare crisis and produced a large healthcare burden. Diabetes mellitus (DM) is a common disease that can be controlled via pharmacologic agents; however, many patients have poor glycemic control, leading to disease-related complications. DM has been reported in the literature to be associated with increasing morbidity and mortality in COVID-19 patients. The authors aim to assess the associations between glucose homoeostasis and COVID-19 disease severity and mortality. Methods: A retrospective chart review of patients ages 18-100 years of age admitted with COVID-19 between January 2020 and December 2021 was performed. The primary outcome was COVID-19 mortality with respect to haemoglobin A1C levels of less than 5.7%, 5.7-6.4%, and 6.5% and greater. Disease severity was determined by degree of supplemental oxygen requirements (ambient air, low-flow nasal cannula, high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation). COVID-19 mortality and severity were also compared to blood glucose levels on admission as grouped by less than 200 mg/dl and greater than or equal to 200 mg/dl. Results: A total of 1156 patients were included in the final analysis. There was a statistically significant association between diabetic status and mortality ( P =0.0002). Statistical significance was also noted between admission blood glucose ≥200 mg/dl and mortality ( P =0.0058) and respiratory disease severity ( P =0.0381). A multivariate logistic regression for predicting mortality showed increasing haemoglobin A1C was associated with increased mortality (odds ratio 1.72 with 95% CI of 1.122-2.635). Conclusions: In our 2-year retrospective analysis, there was an association between a diagnosis of DM and COVID-19-related mortality. Hyperglycaemia on admission was found to be statistically significant with mortality in patients diagnosed with COVID-19. Glucose homoeostasis and insulin dysregulation likely play a contributing factor to COVID-19 disease severity and mortality. Competing Interests: The authors declare there is no conflict of interest. (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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