We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
BIO-RAD LABORATORIES

Download Mobile App




Hyperglycemia and Hypoglycemia Associated with Poor Outcomes in COVID-19 Patients

By LabMedica International staff writers
Posted on 28 Dec 2020
Print article
Image: Blood glucose monitor showing a higher than normal result that could lead to hyperglycemia (Photo courtesy of Diabetes Self-Management).
Image: Blood glucose monitor showing a higher than normal result that could lead to hyperglycemia (Photo courtesy of Diabetes Self-Management).
Diabetes and hyperglycemia have emerged as important risk factors for hospitalization, disease severity, acute kidney injury, acute respiratory distress syndrome, intensive care unit (ICU) admissions, and death in patients with coronavirus disease 2019 (COVID-19).

Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in the blood drops below normal. Hyperglycemia is defined as having an abnormally high blood glucose. This condition is more common in Type 2, or non-insulin-dependent diabetics. It can also occur in Type 1 diabetics who consume carbohydrate-heavy foods without enough insulin afterwards.

A team of scientists working with the Mills-Peninsula Medical Center (San Mateo, CA, USA) analyzed pooled data from the Glytec national database (Waltham, MA, USA) including 1,544 patients with COVID-19 from 91 hospitals in 12 states. Patients were stratified according to achieved mean glucose category in mg/dL (≤7.77, 7.83–10, 10.1–13.88, and >13.88 mmol/L; ≤140, 141–180, 181–250, and >250 mg/dL) during days 2–3 in non-ICU patients or on day 2 in ICU patients. The team conducted a survival analysis to determine the association between glucose category and hospital mortality.

The investigators reported that in non-ICU patients, severe hyperglycemia (blood glucose ≥250 mg/dL) on days 2 to 3 was independently associated with high mortality (adjusted hazard ratio [aHR] = 7.17) compared with patients with blood glucose <140 mg/dL. This relationship was not significant for admission glucose (HR = 1.465). In patients admitted directly to the ICU, severe hyperglycemia on admission was associated with increased mortality (aHR = 3.14). This relationship was not significant on day 2 (HR = 1.40). Hypoglycemia (blood glucose <70 mg/dL) was also associated with increased mortality (odds ratio = 2.2). Of the patients, 279 (18.1%) died in the hospital. The mortality for ICU patients (31%) was almost twice that in the non-ICU population (16%).

Of the non-ICU patients, 40% had diabetes and average admission blood glucose level was 159.5 ± 78.6 mg/dL. The incidence of adverse outcomes included transfer to the ICU (34%), hypoglycemia (20%), acute kidney injury (21%), and mortality (16%). The median length of stay was 7.87 days before discharge or death, and the median time from admission to ICU transfer was 2.24 days for the 34% who transferred to the ICU. Of the ICU patients, 40% had diabetes and the average blood glucose level was 181.3 ± 105.6 mg/dL. The incidence of adverse outcomes included hypoglycemia (20%), acute kidney injury (27%), and mortality (31%). The median length of stay was 9.06 days before discharge or death.

David C. Klonoff, MD, an Endocrinologist and the lead author of the study, said, “The greater survival of the individuals with better control after admission compared with patients with uncontrolled glucose levels is clinically meaningful and indicates the need to start treatment of hyperglycemia on admission.” The study was published on December 15, 2020 in the journal Diabetes Care.

Related Links:
Mills-Peninsula Medical Center
Glytec


New
Platinum Member
Flu SARS-CoV-2 Combo Test
OSOM® Flu SARS-CoV-2 Combo Test
Magnetic Bead Separation Modules
MAG and HEATMAG
Anti-Cyclic Citrullinated Peptide Test
GPP-100 Anti-CCP Kit
New
Gold Member
Hemoglobin Testing System
VARIANTnbs

Print article

Channels

Molecular Diagnostics

view channel
Image: The HelioLiver Dx test has met the coprimary and secondary study endpoints in the CLiMB trial (Photo courtesy of Helio Genomics)

Blood-Based Test Outperforms Ultrasound in Early Liver Cancer Detection

Patients with liver cirrhosis and chronic hepatitis B are at a higher risk for developing hepatocellular carcinoma (HCC), the most prevalent type of liver cancer. The American Association for the Study... Read more

Hematology

view channel
Image: The CAPILLARYS 3 DBS devices have received U.S. FDA 510(k) clearance (Photo courtesy of Sebia)

Next Generation Instrument Screens for Hemoglobin Disorders in Newborns

Hemoglobinopathies, the most widespread inherited conditions globally, affect about 7% of the population as carriers, with 2.7% of newborns being born with these conditions. The spectrum of clinical manifestations... Read more

Microbiology

view channel
Image: The POC PCR test shortens time for STI test results (Photo courtesy of Visby Medical)

POC STI Test Shortens Time from ED Arrival to Test Results

In a 2024 sexually transmitted infections (STIs) surveillance report by the World Health Organization (WHO), over 2.5 million cases were recorded, alongside a rise in the inappropriate use of antibiotics... Read more

Industry

view channel
Image: For 46 years, Roche and Hitachi have collaborated to deliver innovative diagnostic solutions (Photo courtesy of Roche)

Roche and Hitachi High-Tech Extend 46-Year Partnership for Breakthroughs in Diagnostic Testing

Roche (Basel, Switzerland) and Hitachi High-Tech (Tokyo, Japan) have renewed their collaboration agreement, committing to a further 10 years of partnership. This extension brings together their long-standing... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.