Clinical Study of Hyperglycemia and SARS-CoV-2 Infection in Intensive Care Unit Patients

In Vivo. 2020 Sep-Oct;34(5):3029-3032. doi: 10.21873/invivo.12136.

Abstract

Background/aim: Reports indicate that coronaviridae may inhibit insulin secretion. In this report we aimed to describe the course of glycemia in critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Patients and methods: We studied 36 SARS-CoV-2 patients (with no history of diabetes) in one intensive care unit (ICU). All the patients were admitted for hypoxemic respiratory failure; all but four required mechanical ventilation. The mean (±SD) age of the patients was 64.7 (9.7) years; 27 were men; the mean (±SD) duration of ICU stay was 12.9 (8.3 days).

Results: Twenty of 36 patients presented with hyperglycemia; brief intravenous infusions of short-acting insulin were administered in six patients. As of May 29 2020, 11 patients had died (seven with hyperglycemia). In 17 patients the Hyperglycemia Index [HGI; defined as the area under the curve of (hyper)glycemia level*time (h) divided by the total time in the ICU] was <16.21 mg/dl (0.90 mmol/l), whereas in three patients the HGI was ≥16.21 mg/dl (0.90 mol/l) and <32.25 mg/dl (1.79 mmol/l).

Conclusion: In our series of ICU patients with SARS-CoV-2 infection, and no history of diabetes, a substantial number of patients had hyperglycemia, to a higher degree than would be expected by the stress of critical illness, lending credence to reports that speculated a tentative association between SARS-CoV-2 and hyperglycemia. This finding is important, since hyperglycemia can lead to further infectious complications.

Keywords: Coronaviridae; human; hyperglycemia; intensive care units; severe acute respiratory syndrome.

MeSH terms

  • Betacoronavirus / pathogenicity
  • Blood Glucose / metabolism
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / virology
  • Diabetes Mellitus / genetics
  • Diabetes Mellitus / therapy*
  • Diabetes Mellitus / virology
  • Female
  • Hospitalization
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / therapy*
  • Hyperglycemia / virology
  • Insulin / metabolism*
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / virology
  • Respiration, Artificial
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy
  • SARS-CoV-2
  • Severe Acute Respiratory Syndrome / complications
  • Severe Acute Respiratory Syndrome / therapy
  • Severe Acute Respiratory Syndrome / virology

Substances

  • Blood Glucose
  • Insulin