TY - JOUR
T1 - Elevated Fasting Blood Glucose Levels Are Associated with Worse Clinical Outcomes in COVID-19 Patients Than in Pneumonia Patients with Bacterial Infections
AU - Wang, Wenjun
AU - Chai, Zhonglin
AU - Cooper, Mark E.
AU - Zimmet, Paul Z.
AU - Guo, Hua
AU - Ding, Junyu
AU - Yang, Feifei
AU - Lin, Xixiang
AU - Chen, Xu
AU - Wang, Xiao
AU - Zhong, Qin
AU - Li, Zongren
AU - Zhang, Peifang
AU - Wu, Zhenzhou
AU - Guan, Xizhou
AU - Zhang, Lei
AU - He, Kunlun
N1 - Funding Information:
This work was supported by the Ministry of Industry and Information Technology of China (2020-0103-3-1) and the Beijing Science and Technology Project (No. Z201100005420022).
Publisher Copyright:
© 2022 by the authors.
PY - 2022/8
Y1 - 2022/8
N2 - Aims: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections. Methods: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity. Results: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80–37.96), 5.72 (2.95–11.06), 2.60 (1.20–5.32), 1.42 (1.26–1.59), and 5.16 (3.26–8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21–6.29]; 1.56 [1.17–2.07]; 0.98 [0.88–1.11]; 2.06 [1.26–3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36–6.41]; 2.31 [1.76–3.05]; 1.21 [0.97–1.52]; 1.02 [0.93–1.13]; 1.72 [1.19–2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher. Conclusions: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
AB - Aims: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections. Methods: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity. Results: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80–37.96), 5.72 (2.95–11.06), 2.60 (1.20–5.32), 1.42 (1.26–1.59), and 5.16 (3.26–8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21–6.29]; 1.56 [1.17–2.07]; 0.98 [0.88–1.11]; 2.06 [1.26–3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36–6.41]; 2.31 [1.76–3.05]; 1.21 [0.97–1.52]; 1.02 [0.93–1.13]; 1.72 [1.19–2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher. Conclusions: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
KW - clinical severities
KW - COVID-19
KW - fasting blood glucose
KW - pneumonia patients
UR - https://www.scopus.com/pages/publications/85137397706
U2 - 10.3390/pathogens11080902
DO - 10.3390/pathogens11080902
M3 - Article
C2 - 36015023
AN - SCOPUS:85137397706
SN - 2076-0817
VL - 11
JO - Pathogens
JF - Pathogens
IS - 8
M1 - 902
ER -
SDG 3 Good Health and Well-being