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High blood sugar without diabetes linked to covid-19 death risk

Date: 12 July 2020 Tags: Miscellaneous

Issue

Patients with COVID-19 who have elevated blood sugar levels without a previous diagnosis of diabetes may be at a high risk of death and an increased risk of severe complications from the infectious disease.

 

Background

Earlier studies had established high blood sugar as associated with an increased risk of mortality and poor outcomes in COVID-19 patients.

 

Details

  • However, a direct correlation between fasting blood glucose (FBG) level at admission to hospital, and clinical outcomes of COVID-19 patients, without diagnosed diabetes, has not been well established.

  • The scientists assessed patients’ demographic and clinical data, 28-day outcomes, in-hospital complications, and CRB-65 scores -- a measure for assessing the severity of pneumonia based on four indicators, including the level of confusion, respiratory rate, blood pressure, and age.

  • A total of 605 COVID-19 patients were enrolled in the study, including 114 who died in the hospital. According to the study, the median age of participants was 59 years and 322 were men.

  • A total of 208 individuals had one or more underlying conditions but were not diagnosed with diabetes, adding that high blood pressure was the most common co-morbidity.

  • The study noted that a further 17 percent were in the range that would be considered pre-diabetic, while more than half were in the ‘normal’ FBG range.

  • The researchers said patients in the highest FBG group were 2.3 times more likely to die than those in the lowest.

  • They said men were 75 percent more likely to die than women, and that patients with higher CRB65 scores were also at higher risk of death.

  • This study shows that elevated FBG at admission is independently associated with increased 28-day mortality and percentages of in-hospital complications in COVID-19 patients without a previous diagnosis of diabetes.

  • They said critically ill patients may develop acute insulin resistance, manifested by high levels of blood sugar and insulin levels.

  • Patients with conditions not related to diabetes, such as severe sepsis, systemic inflammatory response syndrome (SIRS), and traumatic brain injury tend to have abnormally high blood sugar.

  • The authors suggest that possible mechanisms for this increased mortality include high blood glucose-induced changes in blood clotting, worsening of the function of the walls of blood vessels, and overproduction of inflammatory immune-system molecules. 

  • Blood sugar testing and control should be recommended to all COVID-19 patients even if they do not have pre-existing diabetes, as most COVID-19 patients are prone to glucose metabolic disorders.