At-admission HbA1c levels in hospitalized COVID-19 participants with and without known diabetes

Background: To examine glycaemic status, and the impact of at-admission HbA1c levels on outcome, in a large group of participants hospitalized for COVID-19. Methods: We inclued 515 participants with confirmed COVID-19 infection, with or without known diabetes, who met the following additional criteria: 1) age > 18 years, 2) HbA1c was determined at admission; 3) fasting plasma glucose was determined in the week of admission, and 4) discharge or death was reached before the end of the study. We examined attributes of participants at admission and 3-6 months post-discharge. To assess the associations of pre-admission attributes with in-hospital mortality, logistic regression analyses were performed. Results: Mean age was 70 years, 98.8% were of white race, 49% were female, 31% had known diabetes (KD), an additional 7% met the HbA1c criterion for diabetes, and 13.6% died. In participants with KD, FPG and HbA1c levels were not associated with mortality in adjusted analyses; however, in participants without KD, whereas FPG showed direct association with mortality, HbA1c showed slight inverse association. Conclusions: There was a very high prevalence of people without KD with HbA1c levels above normal atadmission. This alteration does not seem to have been related to blood glucose levels.

Automated summary

This study examines the glycaemic status and the impact of at-admission HbA1c levels on the outcome of COVID-19 hospitalized patients. The results show that in participants with known diabetes, blood glucose and HbA1c levels are not associated with mortality, while in participants without known diabetes, blood glucose is positively associated with mortality, and HbA1c is slightly inversely associated with mortality.