Table III.
Summary of studies assessing the association between non-diabetic impaired glucose regulation and SARS-CoV-2 infection and/or COVID-19 outcomes
| Study | Country | N | Mean Age±SD (range) | Male (%) | Study design | Prediabetes/IFG assessment | Outcome | SARS-CoV-2 Assessment | Study population | Adjustments | Measure of Association (95% Confidence Interval) |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mamtani et al. 2021 | USA | 403 | 55 | 68% | Cohort study | Hyperglycemia [atleast one blood glucose ≥7.78 mmol/L during hospitalization with no history of diabetes | Mortality | Positive PCR for the RdRp and N genes. | Single center study, COVID-19 patients hospitalized from March-May 2020 | 1,27-32 | OR 21.94 (4.04–119.0) |
| Wanget al. 2020 | China | 605 | 59 (47-68)* | 53% | Cohort study | EHR/FBG 6.1-6.9 mmol/l | 28-day mortality and in hospital complications | Laboratory-confirmed in accordance with the interim guidance formulated by the WHO | Multicenter study, Patients hospitalized with COVID-19 from Jan-Feb 2020 | 1,2,40$ | 28-day in hospital complications OR: 2.61 (1.64, 4.41) 28-day mortality$ HR 1.71 (0.99, 2.94) Ref:FBG <6.1 mmol/l |
| Zhang et al. 2020 | China | 312 | 57 (38-66)* | 45% | Cohort study | IFG - glucose b/w 5.6 -6.9 mmol/L. | a) composite end-point events (including mechanical ventilation, admission to ICU/death) b)mortality c)mechanical ventilation | Positive RT-PCR of nasopharyngeal swab or positive serum specific IgM and IgG antibody |
Multicenter study, Patients hospitalized with COVID-19 from Jan-Mar 2020 | 1,2,11,12, 43-46 |
a) 1.21 (0.43–3.39) b) HR 4.06 (1.00–16.42) c)0.95 (0.25–3.66) |
| Sourij et al. 2021 | Austria | 238 | 71±13 | 64% | Cohort study | HbA1c 39-46 mmol/mol | Mortality | Positive throat swab for SARS‐CoV‐2 | Hospitalized, with COVID-19, and either diabetes/ prediabetes | None | Prediabetes: 14.9% versus Diabetes:26.7% (p=0.128) |
| Li et al. 2020 | China | 453 | 61 (49-68)* | 53% | Cohort study | Hyperglycemia (fasting glucose 5.6-6.9 mmol/L and/or HbA1c 5.7-6.4%) | Mortality | Exposure to confirmed SARS-CoV-2 infection or to the Wuhan Huanan seafood market. |
Patients admitted with lab‐confirmed SARS‐Cov‐2 infection from Jan-Mar 2020. | 1,2,19,47-53 | HR: 2.64 (0.50-14) |
| Ren et al. 2020 | China | 151 | 59±16 | 52% | Cohort study | EHR-Triglyceride and glucose index (TyG)-marker for insulin resistance | Severe covid 19 infection and mortality | Severe: 1. respiratory rate > 30/min, 2. oxygen saturation ≤ 93%, 3. PaO2/FiO2, 4. Patients developed either with shock, or respiratory failure requiring mechanical ventilation, or combined with the other organ failure admission to ICU |
Hospitalized with COVID-19, from Jan-Feb,2020 | 1,2,17,26, 31 | OR 2.9 (1.2-6.3)- severity OR 2.9 (1.2-6.7)-for mortality |
| Vargas-Vázquez et al. 2020 | Mexico | 317 | 57 (47–64)* | NR | Cohort study | using HbA1c ADA criteria | Severe COVID-19: composite of death, ICU admission or mechanical ventilation | Positive RT-PCR | Hospitalized patients from a Mexico City reference center | 1,2,15,26 | OR 3.25 (1.20-10.46) |
| Koh et al. 2021 | Singapore | 1,042 | 39±11 | 95% | Cohort study | EHR, HbA1c 5.7–6.4% | Severe COVID-19 | Positive RT‐PCR throat/nasopharyngeal swab | Single center study with patients admitted from Feb-May,2020 | 1,2,15,17, 42 | HR: 0.49 (0.11–2.24) |
| Zheng et al. 2021 | China | 71 | 61±14(IFG) 54±14(no DM) | 44% (IFG) 38% (no DM) | Cohort study | EHR | Hospitalization days, mortality | Positive RT-PCR -throat swab or typical CT findings of COVID-19 or SARS-CoV-2 IgM/IgG antibody | Single center study, with COVID positive inpatients from Feb-Mar 2020 | 15 | IFG no different than normal for hospitalization days, or mortality. |
Adjustments: 1=Age; 2=Sex; 3=Race; 4=Ethnicity; 5=Obesity; 6=Comorbidities; 6a=chronic respiratory disease 6b=Asthma; 6c=HT; 6d=chronic heart disease/cardiovascular disease/CAD; 6e=chronic renal disease;
6f=chronic liver disease; 6g=chronic neurological disease; 6h=Immunosuppression; 6i=COPD; 6j=heart failure; 6k=Atrial fibrillation; 6l=hematological disorders; 6m=rheumatologic/autoimmune disorder;
7=deprivation; 8=geographical region; 9=previous hospital admissions with coronary heart disease, cerebrovascular disease, or heart failure; 10=History of diabetes; 11=LFT; 12=eGFR; 13=glucose on admission;
14=NT‐proBNP (per 100 pg/mL); 15=BMI; 16=History of cancer;17=CRP; 18=LDH (per 100 U/L); 19=smoking; 20=Lymphocyte count (per 1 × 109/L); 21=WBC count; 22=Treatment with ACE/ARB's; 23=blood glucose;
24=Serum ferritin (per 100 μg/L); 25=Hba1c; 26=Number of comorbidities; 27=Differential neutrophil count; 28=Hematuria; 29=Initial serum globulin (g/L); 30=Fever with chills; 31=Marijuana use;
32=Platelet count (x109 cells/L); 33=CD3, CD4, CD8; 34=Coagulation function (34a,Fbg; 34b,D dimer); 35=IL-6; 36=Chest distress/dyspnea/chest tightness; 37=BUN; 38=Creatinine kinase; 39=CTnI;
40=CRB-65 measures the severity of pneumonia on a 0 to 4 scale; 41=QTc prolongation; 42=≥2 comorbidities; 43=Prothrombin time; 44=Procalcitonin; 45=aspartate aminotransferase (AST);
46=hospital; 47=systolic blood pressure; 48=total cholesterol; 49=antihypertensive drugs, lipid-lowering agents; 50=admission to ICU; 51=invasive mechanical ventilation;
52=glucose-lowering medication before and during hospital admission ; 53=corticosteroid use; 54=cognitive impairment;55=Area of lung injury>50%
Median (IQR).