Fasting blood glucose levels upon admission tied to COVID-19 prognosis, study finds

By Angela Betsaida B. Laguipo, BSNSep 28 2020

Nine months into the coronavirus pandemic, the global case toll has now topped 33 million, with over one million deaths. As the global health crisis continues to wreak havoc, scientists are finding more links between underlying medical conditions and severe coronavirus disease (COVID-19).

A team of researchers at the Universitas Indonesia in Jakarta, Indonesia, has found that the fasting blood glucose (FBG) levels are tied to poor prognosis in COVID-19 patients.

In the study, which appeared on the pre-print open-source medRxiv* server, the investigators aimed to determine the prognostic value of blood glucose in predicting outcomes in COVID-19 disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The team wanted to investigate the poor composite outcomes in patients admitted in the hospital due to the viral infection, including severity and mortality.

Study: High admission blood glucose is an independent risk factor of poor prognosis in COVID-19: A systematic review and dose-response meta-analysis. Image Credit: PENpics Studio / Shutterstock

Blood sugar and COVID-19

A previous study has associated diabetes with the development of severe COVID-19, which may lead to serious complications and even death. People with diabetes are not more likely to contract the infection. Still, once infected, they are twice as likely than others to develop a severe infection and are at a higher risk of being admitted to the intensive care unit.

COVID-19 has significantly impacted people living with diabetes through their finances, food and medication scarcity, and burden on mental health. Aside from that, they are at an elevated risk of developing serious complications if the virus infects them.

The study

To arrive at the study findings, the research team included and studied all eligible studies evaluating the prognosis of COVID-19 patients with fasting blood glucose (FBG) and random blood glucose (RBG) upon admission. The studies tackled on using FBG and RBG levels in predicting COVID-19 outcomes.

Overall, the team collected 35 studies involving a total of 14,502 patients and found that there is an independent relationship between admission FBG and severity of COVID-19.

High admission FBG increased the risk of poor outcomes by as much as 20 percent. However, the team was unable to establish strong proof as the observed heterogeneity remained unclear.

In terms of severity, the team also found that high levels of admission FBG have been tied to an increased risk of developing severe COVID-19 infection by more than three-folds. Further, each 1 mmol/L increase in FBG levels heightened the risk of developing severe coronavirus infection by 33 percent.

The study authors also noted that the effects were more highlighted in patients without a medical history of diabetes, where high levels of FBG upon admission elevated the risk of poor COVID-19 outcomes for diabetic patients by 10 percent, and non-diabetic patients by a staggering 75 percent.

“High level of FBG at admission was independently associated with poor prognosis in COVID-19 patients. Further researches to confirm the observed prognostic value of admission RBG and to ascertain the estimated dose-response risk between admission FBG and on COVID19 severity is required,” the team concluded.

The team further stated that the findings show the potential use of admission blood glucose as a predictor for poor prognosis in COVID-19 patients.

The coronavirus pandemic has impacted many countries such as the United States, with a  case toll reaching 7.14 million and deaths topping 205,000. India and Brazil follow with more than 6 million and 4.74 million cases, respectively.