Clinical outcomes in patients with diabetes and stress hyperglycemia that developed SARS-CoV-2 infection

Abstract

Introduction. Diabetes and stress hyperglycemia (SH) have been related with poorer clinical outcomes in patients infected by SARS-CoV-2 and at risk for severe disease.
Objective. To evaluate clinical outcomes in three groups of patients (with diabetes, without diabetes and stress hyperglycemia [SH]) with SARS-CoV-2 infection.
Materials and methods. A retrospective cohort study was conducted in Cali-Colombia. Patients aged ≥18 years with a diagnosis of SARS-CoV-2 infection managed in the emergency room, hospitalization or intensive care unit (ICU) between March 2020 and December 2021 were included. Immunocompromised patients and pregnant women were excluded. Patients were classified in three groups: without diabetes, with diabetes and SH. A comparison between the groups was performed.
Results. A total of 945 patients were included (59.6% without diabetes, 27% with diabetes and 13.4% with SH). Fifty-five-point three percent required ICU management, with a higher need in patients with SH (89.8%) and diabetes (67.1%), with no difference between these groups (p=0.249). A higher chance of death was seen in SH vs. without diabetes (adjOR= 8.12, 95% CI 5.12-12.88, p<0.01). Frequency of acute respiratory distress syndrome, need for invasive mechanical ventilation, use of vasopressors and inotropes, the need for de novo renal replacement therapy and mortality was higher in patients with metabolic alterations (diabetes and SH).
Conclusions. Diabetes and SH are associated to worse clinical outcomes and mortality in patients with COVID-19. These patients should be identified early and considered as high risk at moment of COVID-19 diagnosis that allow to mitigate adverse outcomes.