J-shaped Association Between Fasting Blood Glucose Levels and COVID-19 Severity in Patients without Diabetes

Zhu, Bing; Jin, Shengwei; Wu, Lianpeng; Hu, Chenchan; Wang, Zhen; Bu, Le; Sun, Hang; Wang, Xingchun; Qu, Shen; Chen, Dong

Abstract Aims coronavirus disease 2019 (COVID-19) has become a recognized worldwide pandemic. Researchers now know that mortality from COVID-19 can be reduced through early prevention measures. This retrospective, multi-centered study of 293 COVID-19 patients without diabetes explores the association between fasting blood glucose (FBG) levels and the risk of COVID-19 disease progression, with the goal of providing clinical evidence for glycemic targets in patients. Methods the multivariate stepwise binary logistic regression analysis was used to test the dose-response effects of FBG levels on the risk of severe and critical condition in COVID-19 patients. Results FBG levels were plotted in quintiles with set at < 4.74, 4.74-5.21, 5.21-5.78, 5.78-7.05, and ≧7.05 mmol/L. The constituent ratio of severe or critical cases in each FBG quintile was 20.7%, 1.7%, 13.8%, 27.1%, and 67.2%, respectively (P < 0.0001). When the second quintile was used as the reference, the adjusted odds ratios (AORs) (95%CI) for the risk of severe/critical condition in COVID-19 was 25.33(2.77, 231.64), 1.00 (Reference), 3.13(0.33, 29.67), 10.59(1.23, 91.24), 38.93(4.36, 347.48) per FBG quintile respectively (P < 0.001). Conclusions we provide evidence of J-shaped associations between FBG and risk of severe and critical condition in non-diabetes patients with COVID-19, with nadir at 4.74-5.78 mmol/L.