Correlation of hemoglobin A(1c) and outcomes in patients hospitalized with COVID-19

Patel, Amy J.; Klek, Stanislaw P.; Peragallo-Dittko, Virginia; Goldstein, Michael; Burdge, Eric; Nadile, Victoria; Ramadhar, Julia; Islam, Shahidul; Rothberger, Gary D.

BACKGROUND: Diabetes is a known risk factor for severe coronavirus disease 2019 (COVID-19). We conducted this study to determine if there is a correlation between hemoglobin A(1c) (HbA(1c)) level and poor outcomes in hospitalized patients with diabetes and COVID-19. METHODS: This is a retrospective, single-center, observational study of patients with diabetes (as defined by an HbA(1c) ≥ 6.5% or known medical history of diabetes) who had a confirmed case of COVID-19 and required hospitalization. All patients were admitted to our institution between March 3, 2020 and May 5, 2020. HbA(1c) results for each patient were divided into quartiles; 5.1-6.7% (32-50 mmol/mol), 6.8-7.5% (51-58 mmol/mol), 7.6-8.9% (60-74 mmol/mol), and >9% (>75 mmol/mol). The primary outcome was in-hospital mortality. Secondary outcomes included admission to an intensive care unit, invasive mechanical ventilation, acute kidney injury, acute thrombosis, and length of hospital stay. RESULTS: Five hundred and six patients were included. The number of deaths within quartiles 1 through 4 were 30 (25%), 37 (27%), 34 (27%) and 24 (19%), respectively. There was no statistical difference in the primary or secondary outcomes between the quartiles except acute kidney injury was less frequent in quartile 4. CONCLUSIONS: There is no significant association between HbA(1c) level and adverse clinical outcomes in patients with diabetes who are hospitalized with COVID-19. HbA(1c) should not be used for risk stratification in these patients.