Higher Fasting Plasma Glucose Reduced the Survival Rate of 306 Hospitalized Patients with COVID-19 in Wuhan, China

Abstract

Background: To evaluate the role of diabetes on the progress and mortality of COVID-19 patients, we reported the clinical characteristics and mortality of patients with diabetes in SARS-CoV-2 infection.

Methods: In the single-centered, retrospective study, 306 hospital patients confirmed with SARS-CoV-2 infection (including 129 diabetes and 177 non-diabetes patients) were enrolled in Tongji Hospital, Wuhan, China. Clinical characteristics on admission and outcomes on the 28th day after admission between diabetes and non-diabetes patients were all analyzed.

Findings: Nearly half of the total patients (146/306, 47.7%) were severe or critical ill patients and 160 (52.3%) patients were moderate disease according to Chinese’s guideline for COVID-19. For diabetes group, the age, SOFA and CURB-65 score in diabetes group were elevated compared with non-diabetes. There were significant differences in the biomarkers of bilirubin, renal function, coagulation profiles, cardiac injury parameters and inflammatory cytokines and proteins between the two groups. The rates of respiratory failure and acute cardiac injury in diabetes were greater than non-diabetes. On the 28th day after admission, the mortality of diabetes was much higher than non-diabetes (42.6% vs 10.7 %, p<0.0001). When analysis the independent predictors for mortality of COVID-19 by multivariate analysis, we found the patients with fasting plasma glucose (FPG) ≥ 7.0 mmol/L on admission increase to 3.79 fold risk of mortality than the patients with FPG less than 7.0 mmol/L for COVID-19 infection. The patients with higher FPG had the significant declined survival probability. A fierce rise of random plasma glucose (RPG) from admission to week 2 was observed in deceased diabetes compared with survivors of diabetes patients.

Interpretation: The FPG value equal or more than 7.0 mmol/L was a novel fatality risk factor for COVID-19 patients. The patients with higher FPG had the significant declined survival rate.

Funding Statement:This work is funded by grants from Tongji Hospital for Pilot Scheme Project, and partly supported by the Chinese National Thirteenth Five Years Project in Science and Technology (2017ZX10202201).

Declaration of Interests: All authors declare no competing interests.

Ethics Approval Statement: The ethics commission of Tongji hospital approved the study (TJ-C20200101). Written informed consents were waived due to the rapid emergence of this fatal disease.