Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States

23 avril 2020

Source : Journal of Diabetes Science and Technology

Auteur : Bruce Bode and al.


ANALYSE

“Un article intéressant sur les liens Diabète et Covid aux USA.
Il s’agit d’un travail rétrospectif dont les résultats laissent à penser que l’importance de l’hyperglycémie au moment de l’infection par Covid joue un rôle majeur dans la surmortalité des diabétiques et qu’il est donc indispensable de contrôler au mieux les glycémies le plus tôt possible après les premiers symptômes.” un article proposé par le Dr Laurent MEYER.

Abstract :

Introduction:

Diabetes has emerged as an important risk factor for severe illness and death from COVID-19. There is a paucity of information on glycemic control among hospitalized COVID-19 patients with diabetes and acute hyperglycemia.

Methods:

This retrospective observational study of laboratory-confirmed COVID-19 adults evaluated glycemic and clinical outcomes in patients with and without diabetes and/or acutely uncontrolled hyperglycemia hospitalized March 1-April 6, 2020. Diabetes was defined as A1C > 6.5%. Uncontrolled hyperglycemia was defined as > 2 blood glucoses (BG) > 180 mg/dl within any 24-hour period. Data was abstracted from Glytec’s data warehouse.

Results:

Among 1122 patients in 88 U.S. hospitals, 451 patients with diabetes and/or uncontrolled hyperglycemia spent 37.8% of patient days having a mean BG > 180 mg/dl. Among 570 patients who died or were discharged, the mortality rate was 28.8% in 184 diabetes and/or uncontrolled hyperglycemia patients, compared with 6.2% of 386 patients without diabetes or hyperglycemia (p< 0.001). Among the 184 patients with diabetes and/or hyperglycemia who died or were discharged, 40 of 96 uncontrolled hyperglycemia patients (41.7%) died compared with 13 of 88 diabetes patients (14.8%, p<0.001). Among 493 discharged survivors, those with diabetes and/or uncontrolled hyperglycemia had a longer median length of stay (LOS) compared with their comparison group (5.7 vs 4.3 days, p<0.001).

Conclusions:

Among hospitalized patients with COVID-19, diabetes and/or uncontrolled hyperglycemia occurred frequently . These COVID-19 patients with diabetes and/or uncontrolled hyperglycemia had a longer LOS and markedly higher mortality than patients without diabetes or uncontrolled hyperglycemia. Patients with uncontrolled hyperglycemia had a particularly high mortality rate. We recommend health systems ensure inpatient hyperglycemia is safely and effectively treated.


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