The Effect of Hyperglycemia on Outcome in COVID-19 Patients with Known Diabetes: A Retrospective Observational Study

Abstract

Background: The blood glucose level in a patient with diabetes is an important prognostic factor for any form of severe illness requiring intensive care hospitalization. We conducted this retrospective study to examine the effect of hyperglycemia on outcomes in patients with diabetes with coronavirus diseases (COVID-19) admitted to the intensive care unit (ICU). Method: A retrospective analysis of 25 adult patients with diabetes with COVID-19 admitted to the ICU between 1st January to 15 th February 2021 was done. Demographics details, past medical history, random blood sugar, medical management, ventilatory requirements, and survival data were obtained from medical record files and computerized patient recording systems. Outcomes such as mortality, need for mechanical ventilation, length of ICU stay, and length of hospital stay were analyzed. Result: The median age of the patients was 61 years with a male preponderance. Hypertension is the most common co-morbidity associated with diabetes patients. The median blood sugar level was consistently high in the non-survivors although the result was not statistically significant. Clinical management showed that 84% of patients received insulin, 16% (oral hypoglycemic agents) 72% (steroids) and (64%) mechanical ventilation. The median ICU stay was 8(2-72) days, the median hospital stay was 13(6-79) days and overall mortality in patients with diabetes with COVID-19 was 52%. Conclusion: Hyperglycemia in critically ill COVID-19 patients with preexisting diabetes shows worst outcome in terms of complications, need for mechanical ventilation, and mortality a well-designed prospective study is needed to determine the optimal target for glucose control and its effect on outcomes in patients with diabetes and COVID-19.