Glycemic Dysregulation, Inflammation and Disease Outcomes in Patients Hospitalized with COVID-19: Beyond Diabetes and Obesity

• Published in: Viruses Vol. 15; no. 7; p. 1468
• Main Authors: Liontos, Angelos, Biros, Dimitrios, Kavakli, Aikaterini, Matzaras, Rafail, Tsiakas, Ilias, Athanasiou, Lazaros, Samanidou, Valentini, Konstantopoulou, Revekka, Vagias, Ioannis, Panteli, Aikaterini, Pappa, Christiana, Kolios, Nikolaos-Gavriel, Nasiou, Maria, Pargana, Eleni, Milionis, Haralampos, Christaki, Eirini
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 28.06.2023; MDPI
• Subjects: Complications and side effects; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Diabetes; Diabetes mellitus; Diabetes Mellitus - epidemiology; Disease resistance; Epidemiology; glycemic control; High density lipoprotein; Humans; Hyperglycemia; Hyperglycemia - complications; Hyperglycemia - epidemiology; Inflammation - complications; Insulin Resistance; Interleukin 6; Lung diseases; Morbidity; Mortality; Obesity; Obesity - complications; Obesity - epidemiology; Pandemics; Patients; Pneumonia; Retrospective Studies; SARS-CoV-2; Greece; COVID-19; hyperglycemia; SARS-CoV-2; diabetes mellitus; glycemic control; obesity
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v15071468

During the COVID-19 pandemic, diabetes mellitus (DM) and obesity were associated with high rates of morbidity and mortality. The aim of this study was to investigate the relationship between markers of inflammation, disease severity, insulin resistance, hyperglycemia, and outcomes in COVID-19 patients with and without diabetes and obesity. Epidemiological, clinical, and laboratory data were collected from the University Hospital of Ioannina COVID-19 Registry and included hospitalized patients from March 2020 to December 2022. The study cohort was divided into three subgroups based on the presence of DM, obesity, or the absence of both. In diabetic patients, elevated CRP, IL-6, TRG/HDL-C ratio, and TyG index, severe pneumonia, and hyperglycemia were associated with extended hospitalization. Increased IL-6, NLR, and decreased PFR were associated with a higher risk of death. In the obese subgroup, lower levels of PFR were associated with longer hospitalization and a higher risk of death, while severe lung disease and hyperglycemia were associated with extended hospitalization. In patients without DM or obesity severe pneumonia, NLR, CRP, IL-6, insulin resistance indices, and hyperglycemia during hospitalization were associated with longer hospitalization. Inflammatory markers and disease severity indices were strongly associated with disease outcomes and hyperglycemia across all subgroups.