BACKGROUND Patients with hyperglycemia during hospitalization, especially during ICU hospitalizations, often have worse outcomes, even if they do not have a premorbid diagnosis of diabetes . High glucose levels can provide insight into the underlying pathogenesis of a disease and can contribute to tissue injury . Some patients with COVID-19 have hyperglycemia during hospitalizations .
METHODS The Infectious Disease and Control office at University Medical Center in Lubbock, Texas, provided a list of patients with a COVID-19 infection hospitalized between March 1 and May 15 , 2020 . The medical records were reviewed to collect information on age, gender, history of diabetes, and glucose levels on admission and through the first 7 days of hospitalization .
RESULTS This study included 63 patients with a mean age of 62.1 ± 14.1 years . Thirty-five patients (55.6 %) were males . The in-hospital mortality rate was 30.2% . The mean admission glucose level was 129.4 ± 57.1 mg/dL in patients who survived (N = 47) and 189.6 ± 112.2 mg/dL in patients who died during hospitalization (N = 16, = .007). An admission glucose greater than 180 mg/dL predicted mortality in a model adjusted for a diabetes, age, and male gender . The mean differences between the maximum and minimum glucose levels calculated over the first 7 days of hospitalization were 112.93 ± 115.4 (N = 47) in patients who survived and were 240.5 ± 97.7 (N = 15) in patients who died during hospitalization (= .0003). A difference between the maximum and minimum glucose level greater than 105 mg/dL was associated with increased mortality .
CONCLUSIONS Patients who died during hospitalization for COVID-19 had higher admission glucose levels than patients who survived . Larger differences between maximum and minimum glucose levels during the first 7 days of hospitalization were associated with increased mortality . These results suggest that high glucose levels identify patients at increased risk for mortality and warrant more study.