Admission hyperglycaemia as a predictor of mortality in patients hospitalized with COVID-19 regardless of diabetes status: data from the Spanish SEMI-COVID-19 Registry
Francisco Javier Carrasco-Sánchez, Ma Dolores López-Carmona, Francisco Javier Martínez‐Marcos, Luis M. Pérez-Belmonte, Alicia Hidalgo-Jiménez, Verónica Andrea Buonaiuto, Carmen Busca, Santiago J. Freire Castro, Davide Luordo, Paula María Pesqueira Fontán, Julio César Blázquez Encinar, Jeffrey Óskar Magallanes Gamboa, Andres Fernandez, José D. Torres‐Peña, Joaquím Fernández Solà, J.J. Napal Lecumberri, Martín Jc, María Esther Guisado Espartero, Carlos Jorge Ripper, R. Mendez, Natalia Vicente López, Berta Román Bernal, María Gloria Rojano Rivero, José Manuel Ramos, Ricardo Gómez‐Huelgas, for the SEMI-COVID-19 Network
Abstract
BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: <.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.