Frequency of hyperglycemia in covid-19 patients hospitalized and treated with corticoids

Abstract

INTRODUCTION: during the COVID 19 pandemic, cases of hyperglycemia were reported in hospitalized patients with and without diabetes mellitus. Hyperglycemia could be due to the pro inflammatory state of the disease, use of corticosteroids, direct and indirect damage of the virus to pancreatic cells, endothelial dysfunction, among others. Hyperglycemia is a very common complication in infectious diseases; increases hospital stay, mortality and complications.

OBJECTIVE: to determine the frequency of the development of hyperglycemia in patients with COVID-19 pneumonia treated with corticosteroids.

MATERIALS AND METHOD: observational, retrospective, descriptive study. Patients of both sexes over 18 years of age, with no history of diabetes mellitus, admitted to the Reina Fabiola University Clinic with a diagnosis of pneumonia due to COVID-19 infection and who received corticosteroid treatment were evaluated. For this, medical records were reviewed during the period from March 1, 2021 to October 31, 2021. The following variables were analyzed: Age, sex, family history of diabetes, body mass index (BMI), hospitalized hyperglycemia, defined as plasma glucose greater than or equal to 140 mg/dl, Charlson comorbidity index, history of gestational diabetes and dose of corticosteroid administered. The characteristics of the sample were presented with descriptive statistics; N and percentage for categorical variables and measure of position and dispersion for continuous variables.

RESULTS: in this analysis, 109 patients were included, they had a mean age of (standard deviation, SD) 54.24 (14.50) years of age and the male gender predominated (83%). The mean daily dose (SD) of dexamethasone used was 8.03 (5.15) mg/day and the time required (SD) was an average of 4.8 (2.2) days. Of the total number of patients, N= 76 (67.7%) presented hyperglycemia. Patients with hyperglycemia had a mean age (SD) of 56.32 (14.06), of whom N= 58 (76.3%) were men. In this group family history of diabetes mellitus was positive in N= 50 (65.8%) patients and gestational diabetes in N= 21 (27.6%). In N=51 (67%) patients with hyperglycemia, the Charlson comorbidity index was equal to 0. Finally, the patients with hyperglycemia had a mean (SD) BMI of 30 (5.9); N=23 (30.3%) were overweight and N=41 (52.9%) were obese.

CONCLUSIONS: the frequency of hyperglycemia in hospitalized patients with COVID-19 pneumonia treated with corticosteroids was of 67%. Hyperglycemia occurs more frequently in men, most of whom have a family history of diabetes and a high body mass index.