Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes

• Published in: Cell metabolism Vol. 31; no. 6; pp. 1068 - 1077.e3
• Main Authors: Zhu, Lihua, She, Zhi-Gang, Cheng, Xu, Qin, Juan-Juan, Zhang, Xiao-Jing, Cai, Jingjing, Lei, Fang, Wang, Haitao, Xie, Jing, Wang, Wenxin, Li, Haomiao, Zhang, Peng, Song, Xiaohui, Chen, Xi, Xiang, Mei, Zhang, Chaozheng, Bai, Liangjie, Xiang, Da, Chen, Ming-Ming, Liu, Yanqiong, Yan, Youqin, Liu, Mingyu, Mao, Weiming, Zou, Jinjing, Liu, Liming, Chen, Guohua, Luo, Pengcheng, Xiao, Bing, Zhang, Changjiang, Zhang, Zixiong, Lu, Zhigang, Wang, Junhai, Lu, Haofeng, Xia, Xigang, Wang, Daihong, Liao, Xiaofeng, Peng, Gang, Ye, Ping, Yang, Jun, Yuan, Yufeng, Huang, Xiaodong, Guo, Jiao, Zhang, Bing-Hong, Li, Hongliang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 02.06.2020
• Subjects: Aged; Betacoronavirus - pathogenicity; Blood Glucose - analysis; blood glucose control; Clinical and Translational Report; Coronavirus Infections - complications; Coronavirus Infections - mortality; Coronavirus Infections - pathology; COVID-19; diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Disease Susceptibility - pathology; Female; Glycemic Index - physiology; Hospitalization - statistics & numerical data; Humans; Hyperglycemia - blood; Hyperglycemia - complications; Hypoglycemic Agents - therapeutic use; Longitudinal Studies; Male; Middle Aged; mortality; Multiple Organ Failure - complications; Multiple Organ Failure - mortality; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - mortality; Pneumonia, Viral - pathology; Retrospective Studies; SARS-CoV-2; COVID-19; mortality; SARS-CoV-2; diabetes mellitus; blood glucose control
• ISSN: 1550-4131; 1932-7420; 1932-7420
• DOI: 10.1016/j.cmet.2020.04.021

Type 2 diabetes (T2D) is a major comorbidity of COVID-19. However, the impact of blood glucose (BG) control on the degree of required medical interventions and on mortality in patients with COVID-19 and T2D remains uncertain. Thus, we performed a retrospective, multi-centered study of 7,337 cases of COVID-19 in Hubei Province, China, among which 952 had pre-existing T2D. We found that subjects with T2D required more medical interventions and had a significantly higher mortality (7.8% versus 2.7%; adjusted hazard ratio [HR], 1.49) and multiple organ injury than the non-diabetic individuals. Further, we found that well-controlled BG (glycemic variability within 3.9 to 10.0 mmol/L) was associated with markedly lower mortality compared to individuals with poorly controlled BG (upper limit of glycemic variability exceeding 10.0 mmol/L) (adjusted HR, 0.14) during hospitalization. These findings provide clinical evidence correlating improved glycemic control with better outcomes in patients with COVID-19 and pre-existing T2D. [Display omitted] •A cohort of 7,337 COVID-19 patients with or without diabetes was retrospectively studied•Diabetes status increased the need for medical interventions during COVID-19•Diabetes status increased the mortality risk of patients with COVID-19•Well-controlled blood glucose correlated with improved outcomes in infected patients Type 2 diabetes (T2D) correlates with a worse outcome for COVID-19. Here, Zhu et al. show that among ∼7,300 cases of COVID-19, T2D is associated with a higher death rate, but diabetics with better controlled blood glucose die at a lower rate than diabetics with poorly controlled blood glucose.