January - March 2023, Volume 19, Issue 1

Ferlicolak L, Yildiz B, Altintas ND

Effects of Diabetes and First-Week Hyperglycemic Episode Frequency on the Mortality and Inflammation in Critically Ill Covid-19 Patients: A Casecontrol Study

Acta Endo (Buc) 2023, 19 (1): 49-53
doi: 10.4183/aeb.2023.49

Background. We know that mortality had increased in diabetic patients with COVID-19 pneumonia. The aim of this study was to compare the mortality and inflammation parameters difference in critically ill COVID-19 patients according to their admission HbA1c levels and diabetes mellitus status. Secondary aim was to evaluate the effect of the first week hyperglycemic episode frequency on mortality. Methods. Critically ill COVID-19 patients who were tested for HbA1c levels on ICU admission were analyzed retrospectively. Results. Of 218 COVID PCR(+) patients, 139 met the inclusion criteria in study period. The median age was 67[57-76] years and 55(40%) of them were female. Seventy-six (55%) of the patients required invasive mechanical ventilation (IMV). The IMV requirement was higher in diabetic patients (p=0.01). When the groups were compared in terms of inflammatory parameters no significant difference was found except for admission and first week’s highest fibrinogen levels (p=0.02 and p=0.03, respectively). In multivariate analysis, fibrinogen levels were not determined as a risk factor for mortality. Overall ICU mortality was 43% (60/139). In group-1 23(37%), in group-2 27(57%), and in group-3 10(34%) patients had died. There was no statistically significant difference between groups in terms of mortality (p=0.05). Records of 96(69%) patients revealed there were more than five glucose readings over 180mg/dL during the first week. Mortality was higher in patients with more frequently hyperglycemic recordings (p=0.03). Conclusions. There was no significant mortality and inflammatory parameters difference in patients with and without diabetes. However, more than five glucose readings over 180mg/dL during the first week were found with increased mortality.

Keywords: Diabetes, critical care, glycemic control, Covid-19

Correspondence: Leyla Ferlicolak, MD, Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Unit, Ibni Sina Hospital, 06100, Ankara, Turkey, E-mail: lferlicolak@gmail.com