Role of Acute and Chronic Glycemic Control on COVID-19 Severity and Length of Hospital Stay in Hospitalized Patients

Authors

Ali Mossayebi, Department of Kinesiology, University of Texas at El PasoFollow
Helen Kreit, Department of Internal Medicine, Texas Tech UniversityFollow
Sundar Cherukuri, Department of Internal Medicine, Texas Tech UniversityFollow
Roshni A. Mandania, Paul L. Foster School of Medicine, Texas Tech UniversityFollow
Jeannie B. Concha, Department of Public Health, University of Texas at El PasoFollow
Hyejin Jung, Department of Social Work, University of Texas at El PasoFollow
Amy Wagler, Department of Mathematical Sciences, The University of Texas at El PasoFollow
Akshay Gupte, Department of Neurosurgery, University Medical CenterFollow
Abhizith Deoker, Paul L. Foster School of Medicine, Texas Tech UniversityFollow
Sudip Bajpeyi, Department of Kinesiology, University of Texas at El PasoFollow

Abstract

COVID-19 patients with diabetes have greater morbidity and mortality. Glycated hemoglobin (A1c) indicates chronic glycemic control and is considered a standard of care in the diagnosis and management of diabetes. Whereas, fasting blood glucose (FBG) indicates acute glycemic control and is also recommended option to diagnose diabetes. PURPOSE: The purpose of this study was to determine the effects of acute and chronic glycemic control on severity and length of hospital stay among hospitalized patients with COVID-19. METHODS: This retrospective study used medical records from patients admitted to the University Medical Center, El Paso, TX with COVID-19 (n=364; age 60.0 ± 0.8 years; BMI 30.3 ± 0.4 kg/m²). Chronic and acute glycemia were assessed by A1c and FBG at the time of hospitalization. The severity of the COVID-19 outcome was measured by quick sepsis-related organ failure assessment (qSOFA) and the length of hospitalization was determined by the number of days spent in the hospital. Patients were categorized into 4 groups based on chronic and acute glycemia defining diabetes status. G1: diagnosed no diabetes by both A1c and FBG (A1c<6.5%, FBG<126 mg/dl), G2: diagnosed diabetes by FBG but no diabetes by A1c (A1c<6.5%, FBG≥126 mg/dl), G3: diagnosed diabetes by A1c but no diabetes by FBG (A1c≥6.5%, FBG<126 mg/dl), and G4: diagnosed diabetes by both A1c and FBG (A1c≥6.5%, FBG≥126 mg/dl). One-way ANOVA with posthoc Tucky test was used to determine the statistical differences among groups. RESULTS: Patients diagnosed as diabetes by FBG but not A1c (G2) had a greater COVID-19 severity, measured by qSOFA, compared with the other 3 groups. (G2: 0.61 ± 0.14 vs. G1: 0.24 ± 0.05; P<0.004, G2: 0.61 ± 0.14 vs. G3: 0.16 ± 0.06; P<0.001, and G2: 0.61 ± 0.14 vs. G4: 0.31 ± 0.04; P<0.015). Additionally, this study found a greater length of hospitalization in G2 to compare with G1 (G2: 12.91 ± 1.99 vs. G1: 6.36 ± 0.56 days; P<0.002). CONCLUSION: Patients with acute glycemia represent higher severity and longer length of hospital stay among hospitalized COVID-19 patients. Management of FBG should be considered in the treatment of hospitalized COVID-19 patients.

Recommended Citation

Mossayebi, Ali; Kreit, Helen; Cherukuri, Sundar; Mandania, Roshni A.; Concha, Jeannie B.; Jung, Hyejin; Wagler, Amy; Gupte, Akshay; Deoker, Abhizith; and Bajpeyi, Sudip (2021) "Role of Acute and Chronic Glycemic Control on COVID-19 Severity and Length of Hospital Stay in Hospitalized Patients," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 13, Article 45.
Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss13/45