Caracterización clínica, según niveles de glucemia, de pacientes hospitalizados por COVID-19: serie de casos

Abstract

Hyperglycemia, with or without diabetes, is associated with complications in hospitalized patients with COVID-19. There is no information regarding this problem in our region. This study was aimed to compare the characteristics and in-hospital clinical course of patients with a probable diagnosis of COVID-19, with and without hyperglycemia during the hospitalization. This is a retrospective, observational study of clinical records review of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data collection. Hyperglycemia was defined as a fasting value >= 140 mg/dL according to standard glycaemia targets in hospitalized patients. A total of 148 patients were included, 97 (65.5%) men and 51 (34.5%) women, with a mean age of 64.1 +/- 16.1 years;of which 42/148 (28.4%) patients reported previous diabetes, 60/148 (40.5%) patients had hyperglycemia during the hospitalization and 32/60 (53.3%) of these cases did not report previous diabetes. The patients with hyperglycemia were older, received more frequently systemic corticosteroids (96.6 vs 82.6%;p=0.01), and antibiotics (68.3 vs 44.3%;p=0.01), had worse baseline oxygenation parameters (SpO(2) 88.1 +/- 1,1.7%;vs 92.8 +/- 5.5%;p=0.02, PaO2/FiO(2), 194.4 +/- 119.7 vs 270.9 +/- 118.3;p<0.001), higher total lung severity score in the chest CT (14.9 +/- 5.7 vs 11.1 +/- 6.3;p<0.001) and higher levels of baseline inflammatory markers (CRP 6.73 +/- 3.61 vs 5.08 +/- 4.21;p<0.01, LDH 342.9 +/- 118.4 vs 296.5 +/- 161.4;p=0.01 and Ferritin 687.7 +/- 373.2 vs 542.6 +/- 395.3;p=0.01). Mortality (34.5 vs 10.7%;p<0.001) and admission to ICU (43.3 vs 7.9%;p<0.001) were higher in patients with hyperglycemia. Hyperglycemia in hospitalized patients with COVID-19 is a marker of severe disease and poor prognosis.