Objectives

We aimed to assess whether blood glucose control can be used as predictors for severity of COVID-19, and to improve the management diabetic patients with COVID-19.

Methods

A two-center cohort with total of 241 confirmed cases of COVID-19 with definite outcomes were studied. After the diagnosis of COVID-19, the clinical data and laboratory results were collected, the fasting blood glucose (FBG) levels were followed up at initial, middle stage of admission and discharge, the severity of the COVID-19 was assessed at any time from admission to discharge. Hyperglycemia patients with COVID-19 was divided into three groups: good blood glucose control, fair blood glucose control and blood glucose deterioration. The relationship of blood glucose levels, blood glucose control status and severe COVID-19 were analyzed by univariate and multivariable regression analysis.

Results

In our cohort, 21.16% were severe cases and 78.84% were non-severe cases. Admission hyperglycemia (adjusted odds ratio (aOR), 1.938; 95% confidence intervals (95%CI), 1.387-2.707), Mid-term hyperglycemia (aOR, 1.758; 95%CI, 1.325-2.332), and blood glucose deterioration (aOR, 22.783; 95%CI, 2.661-195.071) were identified as the risk factors of severe COVID-19. ROC curve analysis, reaching an AUC of 0.806, and a sensitivity and specificity of 80.40% and 68.40%, respectively, revealed that hyperglycemia on admission and blood glucose deterioration of diabetic patients are potential predictive factors for severe COVID-19.

Conclusions

Admission hyperglycemia and blood glucose deterioration were positively correlated with the risk factor for severe COVID-19, and deterioration of blood glucose may be more likely to the occurrence of severe illness in COVID-19.

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