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Endocr Pract . Impact of hyperglycemia on cardiovascular events and clinical outcomes in patients hospitalized with COVID-19 pneumonia

tetano

Editor, Senior Moderator
Endocr Pract


. 2022 Jun 4;S1530-891X(22)00521-3.
doi: 10.1016/j.eprac.2022.05.011. Online ahead of print.
Impact of hyperglycemia on cardiovascular events and clinical outcomes in patients hospitalized with COVID-19 pneumonia


Sathya Krishnasamy[SUP] 1 [/SUP], Daniya Sheikh[SUP] 2 [/SUP], T'shura Ali[SUP] 3 [/SUP], Victoria Clemons[SUP] 3 [/SUP], Stephen Furmanek[SUP] 3 [/SUP], Ahmed Abdelhaleem Mohamed Fawzy Abdelhaleem[SUP] 3 [/SUP], Vidyulata Salunkhe[SUP] 3 [/SUP], Usman Ali Akbar[SUP] 3 [/SUP], Diane Chlebowy[SUP] 4 [/SUP], Julio Ramirez[SUP] 3 [/SUP], Forest Arnold[SUP] 3 [/SUP]



Affiliations

Abstract

Objective: To study cardiovascular events and clinical outcomes in patients with elevated glycated hemoglobin (HbA1c) and/or admission hyperglycemia and those with type 2 diabetes hospitalized with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia.
Research design and methods: This was a multi-center retrospective study of 1,645 patients hospitalized with SARS-CoV-2 pneumonia. The diagnosis of SARS-CoV-2 pneumonia required a positive reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2, presence of new or worsening pulmonary infiltrates on computed tomography scan or chest X-ray, and at least one of the following: new or increased cough, temperature >37.8 °C or dyspnea. The outcomes included in-hospital cardiovascular events, intensive care unit (ICU) admission and mortality. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for association of elevated HbA1c and/or admission hyperglycemia and type 2 diabetes for individual outcomes.
Results: Among 1,645 adults hospitalized with SARS-CoV-2 pneumonia, 107 (10.8%) patients with no history of diabetes were identified with elevated HbA1c and/or admission hyperglycemia and 634 (39%) had known diagnosis of type 2 diabetes. Patients with elevated HbA1c and/or admission hyperglycemia had increased odds of developing acute in-hospital cardiovascular events (OR: 1.73, 95% CI 1.07, 2.80), ICU admissions (OR: 1.61, 95% CI 1.10, 2.34), and mortality (OR: 1.77, 95% CI 1.02, 3.07), compared to patients with type 2 diabetes and no diabetes.
Conclusions: Patients with elevated HbA1c and/or admission hyperglycemia hospitalized with SARS-CoV-2 pneumonia have an increased risk of developing acute in-hospital cardiovascular complications and overall poor clinical outcomes compared to patients with type 2 diabetes and no diabetes.

Keywords: COVID-19; SARS-CoV-2; cardiovascular events; hyperglycemia; mortality; pneumonia.
 
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