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2021년 제72차 대한내과학회 추계학술대회
￭S-416 ￭ Association of glycemic variability and severity of COVID-19
in Patients with COVID-19 in Korea
명지병원 내과
최인엽, 안지연
Background/Aims: Poor glucose control is known to have association with severity of COVID-19. Not only just simple value of blood sugar, serum glycemic variability also affects the diabetic complications and infections. This study is about the association between severity of COVID-19 and glycemic variability in Korea.
Methods: We conducted the study retrospectively with data from a cohort of 211 confirmed COVID-19 cases enrolled from July 2020 to July 2021 at Myongji hospital in Korea. Severe cases was defined if a patient has respiratory distress with low oxygen saturation and high respiration rate. Among severe cases, those requiring mechanical ventilation or having multiple organ failure were defined as critical cases. In order to know the mean and variability of blood glucose at the initial stage of hospitalization, the mean, standard deviation (SD) and coefficient of variation (CV) values were calculated using serum glucose measured from the beginning of hospitalization to 10 times. Based on the median value, it was divided into high and low groups of mean, SD and CV of blood glucose, and the ratios of severe cases, critical cases, and death in each group were compared.
Results: Clinic characteristics were collected from a total of 147 patients out of 211 confirmed cases of COVID-19. The odd ratios of severe, critical, and death were 17.6 (95% CI 3.47-89.54), 8.8 (95% CI 3.61-21.46), and 27.5 (95% CI 6.18-122.03), respectively, higher in the group with high mean of blood glucose at the beginning of hospitalization than in the low group. The incidence of severe cases and critical cases was very high in the high SD(severe, OR 4.3, 95% CI 1.55-11.82; critical, OR 3.3, 95% CI 1.60-6.87) and high CV groups(severe, OR 4.3, 95% CI 1.55-11.82; critical, OR 2.0, 95% CI 1.03-4.05) compared to each low group. Also, even when corrected for the mean of blood glucose, the OR value was found to be statistically significantly higher(Figure1).
Conclusions: We found that those with greater glycemic variability, tend to show high severity of COVID-19 infection. The severity of this infection can be predicted by using the variability of blood glucose at the beginning of hospitalization, and this can be used clinically.
