Analysis of Glucose Levels in Patients Hospitalized With COVID-19 During the First Phase of This Pandemic in West Texas

J Prim Care Community Health. Jan-Dec 2020;11:2150132720958533. doi: 10.1177/2150132720958533.

Abstract

Background: Patients with hyperglycemia during hospitalization, especially during ICU hospitalizations, often have worse outcomes, even if they do not have a premorbid diagnosis of diabetes. High glucose levels can provide insight into the underlying pathogenesis of a disease and can contribute to tissue injury. Some patients with COVID-19 have hyperglycemia during hospitalizations.

Methods: The Infectious Disease and Control office at University Medical Center in Lubbock, Texas, provided a list of patients with a COVID-19 infection hospitalized between March 1 and May 15, 2020. The medical records were reviewed to collect information on age, gender, history of diabetes, and glucose levels on admission and through the first 7 days of hospitalization.

Results: This study included 63 patients with a mean age of 62.1 ± 14.1 years. Thirty-five patients (55.6%) were males. The in-hospital mortality rate was 30.2%. The mean admission glucose level was 129.4 ± 57.1 mg/dL in patients who survived (N = 47) and 189.6 ± 112.2 mg/dL in patients who died during hospitalization (N = 16, P = .007). An admission glucose greater than 180 mg/dL predicted mortality in a model adjusted for a diabetes, age, and male gender. The mean differences between the maximum and minimum glucose levels calculated over the first 7 days of hospitalization were 112.93 ± 115.4 (N = 47) in patients who survived and were 240.5 ± 97.7 (N = 15) in patients who died during hospitalization (P = .0003). A difference between the maximum and minimum glucose level greater than 105 mg/dL was associated with increased mortality.

Conclusions: Patients who died during hospitalization for COVID-19 had higher admission glucose levels than patients who survived. Larger differences between maximum and minimum glucose levels during the first 7 days of hospitalization were associated with increased mortality. These results suggest that high glucose levels identify patients at increased risk for mortality and warrant more study.

Keywords: COVID-19; glucose; glucose variability; mortality; outcomes.

MeSH terms

  • Aged
  • Blood Glucose / analysis*
  • Coronavirus Infections / blood*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality
  • Coronavirus Infections / therapy*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Hyperglycemia / epidemiology
  • Hyperglycemia / mortality
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / therapy*
  • Risk Assessment
  • Texas / epidemiology
  • Treatment Outcome

Substances

  • Blood Glucose

Supplementary concepts

  • COVID-19