Hyperglycemia as an Independent Predictor for Covid-19 Morbidity and Mortality

Background/Aim: A wealth of immunological evidence points out that hyperglycemic status (regardless of diabetes) makes individuals more susceptible to infection as well as higher in-hospital complications. In this study, we primarily aimed to identify the clinical and biochemical negative impacts of hyperglycemia risk factor across the two comparative cohorts. Secondly, we also explored the prognosticating utilities of three proposed BG related prognosticators in moderate-severe admitted SARS-CoV-2 infected patients. Methods: This study was retrospectively between Mar 2020 and Sep 2021. All retrievable and calculated variables were thereafter divided into two studied cohorts, Survivors Cohort (Cohort I) and Non-Survivors Cohort (Cohort II). Independent and One-Sample T-Tests and Chi-Square Test were used for comparative analysis and relative risk estimation. The Receiver operating characteristic analysis was used to explore the area under the curve and the sensitivity analysis was also performed to investigate the optimal cutoff values for the BG related prognosticators. Results: The mean age of the whole study cohort was 59.40±10.60 years, and the Non-Survivors Cohort were insignificantly younger than the Survivors Cohort. Survivors Cohort had insignificantly higher average blood glucose level than Non-Survivors Cohort. Oppositely, Survivors Cohort had significantly lower average total daily insulin dosing compared to Non-Survivors Cohort. The overall hospital length of stay (LOS) which it was significantly lower in Non-Survivors Cohort compared to Survivors Cohort. Conclusion: As there were many cconcerns for the effect of hyperglycemia on immune cells and subsequently the overall clinical impacts, there is an urgent necessity to track the daily blood glucose levels, the changes in blood glucose from baseline, or alternatively the insulin infusion rate to keep their averages around 149.9 mg/dl, -38%, and 1.35 IU/hr.