COVID‐19 in a country with a very high prevalence of diabetes: The impact of admission hyperglycaemia on mortality

Martínez‐Murillo, Carlos; Ramos Peñafiel, Christian; Basurto, Lourdes; Balcázar‐Hernández, Lourdes; Pellón, Karen; Flores López, Eder; Li Gómez, Beatriz; Ledesma, Mercedes Estefania; Rivera Tapia, Rodrigo; Madera Maldonado, Elizabeth; Bejarano Rosales, Monica; Barranco Lampon, Gilberto; Zazueta, Juan Francisco

AIMS: To evaluate the frequency of diabetes and admission hyperglycaemia in Mexican COVID‐19 patients, to describe the clinical and biochemical characteristics of patients with admission hyperglycaemia and to determinate the impact of diabetes and admission hyperglycaemia on COVID‐19 severity and mortality. METHODS: A multicentric study was performed in 480 hospitalized patients with COVID‐19. Clinical and biochemical characteristics were evaluated in patients with admission hyperglycaemia and compared with non‐hyperglycaemic patients. The effect of diabetes and admission hyperglycaemia on severity and risk of death were evaluated. RESULTS: Age was 50.7 ± 13.6 years; 68.3% were male. Some 48.5% (n = 233) had admission hyperglycaemia; 29% (n = 139) of these patients had pre‐existing diabetes. Patients with admission hyperglycaemia had more requirement of invasive mechanical ventilation (IMV), higher levels of urea, D‐dimer and neutrophil‐lymphocyte ratio (NLR), as well as lower lymphocyte count. An association between admission hyperglycaemia with IMV and D‐dimer with glucose was found. Age ≥50 years (OR 2.09; 95%CI 1.37–3.17), pre‐existing diabetes (OR 2.38; 95%CI 1.59–5.04) and admission hyperglycaemia (OR 8.24; 95%CI 4.74–14.32) were risk factors for mortality. CONCLUSIONS: Admission hyperglycaemia is presented in 48.5% of COVID‐19 patients. Diabetes and admission hyperglycaemia are associated with the severity of disease and mortality. This study shows the devastating conjunction of hyperglycaemia and COVID‐19. Clinical trial registration: Clinical characteristics of patients with COVID‐19, DI/20/204/04/41 (Hospital General de Mexico) and NR‐13‐2020 (Hospital Regional de Alta Especialidad Ixtapaluca).