Glycemic Characteristics and Clinical Outcomes in Patients with COVID-19 Admitted to Referral Shahid Sayad Shirazi Hospital in Gorgan, North of Iran

Abstract

Background. Diabetes mellitus (DM) is one of the most common chronic diseases, the main manifestation of which is hyperglycemia, and is accompanied by many complications. Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, several studies have reported the occurrence of various complications associated with different degrees of hyperglycemia in COVID-19 patients. The aim of the present study was to investigate the glycemic characteristics and clinical outcomes in patients with COVID-19. Methods. In this cross-sectional study, 418 patients with COVID-19 were evaluated in terms of hyperglycemia and its related factors, as well as the relationship between hyperglycemia and the outcome of the disease. Data were statistically analyzed using SPSS software. Results. In the present study, 350 (83.7%) out of 418 hospitalized patients with COVID-19 had hyperglycemia and 193 (55.1%) of the patients with hyperglycemia were women. 169 (48.4%) of patients with hyperglycemia during hospitalization were already diabetic. The mean age was higher in COVID-19 patients with hyperglycemia ( $P$  < 0.001), and systolic blood pressure and respiratory rate were also higher in them ( $P$  = 0.005 and $P$  = 0.013, respectively). In patients with hyperglycemia, oxygen saturation (SpO2) at the time of admission and discharge was lower than other patients ( $P$  < 0.001). The frequency of hypertension in the patients with hyperglycemia was significantly higher than in nonhyperglycemic patients ( $P$  < 0.001 vs. 0.014). The estimated glomerular filtration rate (eGFR) of hyperglycemic patients was significantly lower than other patients ( $P$  < 0.001). Also, there was a significant inverse relationship between eGFR values and fasting (FBS) and random blood sugar (BS) (r = 0.328 and r = 0.310, $P$  < 0.001). On the other hand, there was a direct relationship between FBS and random BS in patients with hyperglycemia with the dose of corticosteroids (r = 0.146 and r = 0.158, $P$  < 0.01). In total, 8.2% of the patients died, although the FBS and random BS and a history of DM were not risk factors for the death of patients ( $P$  < 0.05). Conclusion. The findings of our study showed that hyperglycemia is highly prevalent in hospitalized patients with COVID-19. Hyperglycemia in previously nondiabetics appears to be associated with decreased eGFR in COVID-19 patients.