Association between Hyperglycemia at Hospital Presentation and Hospital Outcomes in COVID-19 Patients with and without Type 2 Diabetes: A Retrospective Cohort Study of Hospitalized Inner-City COVID-19 Patients.
TL;DR: In this paper, the authors investigated the relationship among hyperglycemia (HG), the presence of type 2 diabetes (T2D), and the outcomes of COVID-19.
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Abstract: This study aimed to determine the relationships among hyperglycemia (HG), the presence of type 2 diabetes (T2D), and the outcomes of COVID-19. Demographic data, blood glucose levels (BG) measured on admission, and hospital outcomes of COVID-19 patients hospitalized at Boston University Medical Center from 1 March to 4 August 2020 were extracted from the hospital database. HG was defined as BG > 200 mg/dL. Patients with type 1 diabetes or BG < 70 mg/dL were excluded. A total of 458 patients with T2D and 976 patients without T2D were included in the study. The mean ± SD age was 56 ± 17 years and 642 (45%) were female. HG occurred in 193 (42%) and 42 (4%) of patients with and without T2D, respectively. Overall, the in-hospital mortality rate was 9%. Among patients without T2D, HG was statistically significantly associated with mortality, ICU admission, intubation, acute kidney injury, and severe sepsis/septic shock, after adjusting for potential confounders (p < 0.05). However, only ICU admission and acute kidney injury were associated with HG among patients with T2D (p < 0.05). Among the 235 patients with HG, the presence of T2D was associated with decreased odds of mortality, ICU admission, intubation, and severe sepsis/septic shock, after adjusting for potential confounders, including BG (p < 0.05). In conclusion, HG in the subset of patients without T2D could be a strong indicator of high inflammatory burden, leading to a higher risk of severe COVID-19.
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Fabiola Olivieri,Jacopo Sabbatinelli,Anna Rita Bonfigli,Riccardo Sarzani,Piero Giordano,Antonio Cherubini,Roberto Antonicelli,Y. Rosati,Simona Del Prete,Mirko Di Rosa,Andrea Corsonello,Roberta Galeazzi,Antonio Domenico Procopio,Fabrizia Lattanzio +13 more
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TL;DR: DKA and NKH are associated with elevation of proinflammatory cytokines, ROS, and cardiovascular risk factors in the absence of obvious infection or cardiovascular pathology, and return of these values to normal levels with insulin therapy demonstrates a robust anti-inflammatory effect of insulin.
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Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome.
TL;DR: Diabetic patients with COVID-19 patients are at higher risk of ICU admission and show an higher mortality risk and statistical heterogeneity between groups was measured using the Higgins I2 statistic.
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