The clinical characteristics and outcomes of patients with diabetes and secondary hyperglycaemia with coronavirus disease 2019: A single-centre, retrospective, observational study in Wuhan

Diabetes Obes Metab. 2020 Aug;22(8):1443-1454. doi: 10.1111/dom.14086. Epub 2020 Jun 17.

Abstract

Aim: To explore whether coronavirus disease 2019 (COVID-19) patients with diabetes and secondary hyperglycaemia have different clinical characteristics and prognoses than those without significantly abnormal glucose metabolism.

Materials and methods: We retrospectively analysed 166 COVID-19 patients at Tongji Hospital (Wuhan) from 8 February to 21 March 2020. Clinical characteristics and outcomes (as of 4 April 2020) were compared among control (group 1), secondary hyperglycaemia (group 2: no diabetes history, fasting plasma glucose levels of ≥7.0 mmol/L once and HbA1c values <6.5%) and patients with diabetes (group 3).

Results: Compared with group 1, groups 2 and 3 had higher rates of leukocytosis, neutrophilia, lymphocytopenia, eosinopenia and levels of hypersensitive C-reactive protein, ferritin and d-dimer (P < .05 for all). Group 2 patients had higher levels of lactate dehydrogenase, prevalence of liver dysfunction and increased interleukin-8 (IL-8) than those in group 1, and a higher prevalence of increased IL-8 was found in group 2 than in group 3 (P < .05 for all). The proportions of critical patients in groups 2 and 3 were significantly higher compared with group 1 (38.1%, 32.8% vs. 9.5%, P < .05 for both). Groups 2 and 3 had significantly longer hospital stays than group 1, which was nearly 1 week longer. The composite outcomes risks were 5.47 (1.56-19.82) and 2.61 (0.86-7.88) times greater in groups 2 and 3 than in group 1.

Conclusions: Hyperglycaemia in both diabetes and secondary hyperglycaemia patients with COVID-19 may indicate poor prognoses. There were differences between patients with secondary hyperglycaemia and those with diabetes. We recommend that clinicians pay more attention to the blood glucose status of COVID-19 patients, even those not diagnosed with diabetes before admission.

Keywords: cohort study, type 2 diabetes.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • Blood Glucose / analysis
  • China / epidemiology
  • Coronavirus Infections / blood*
  • Coronavirus Infections / complications
  • Coronavirus Infections / mortality
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / mortality
  • Diabetes Mellitus / virology*
  • Female
  • Glycated Hemoglobin A / analysis
  • Hospitalization / statistics & numerical data
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / mortality
  • Hyperglycemia / virology*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / mortality
  • Prognosis
  • Retrospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2