Diabetes Mellitus and COVID-19: A Not So Sweet Combination

Diabetes Mellitus (DM) and hyperglycemia are often noted as risk factors for increased severity of COVID-19 infection. However, the exact correlation between DM and COVID-19 is not well understood. The aim of this study is to identify if there is any correlation between glycated hemoglobin (HbA1c) levels and severity of COVID-19 infection including increased mortality, need for intubation, need for intensive care unit (ICU), and hospital length of stay.

Methods:

This is a retrospective cohort study of patients admitted to Community Regional Medical Center and Clovis Community Medical Center in the Central Valley, California. We reviewed a cohort of 317 patients who were admitted to the hospital between March 1, 2020 and September 1, 2020. Patients were selected based on an ICD-10 diagnosis of confirmed COVID-19 infection and had an HbA1c level available during hospital admission or within the past 30 days prior to admission. Using the integrated electronic medical records system, we were able to collect clinical information including age, sex, ethnicity, race, body mass index, HbA1c, hospital length of stay, and need for ICU level of care. Data was analyzed through the Pearson correlation method and regression model.

Results:

A total of 317 patients were reviewed of which 202 patients met the inclusion criteria of the study. Of the 202 patients, 99 were male (49%) and 103 were female (51%). There was a similar distribution between non-Hispanic (49%) and Hispanic (51%), although the majority of the race were Caucasian (79.7%). 157 patients (77%) had a HbA1c value of 0-8 and 45 patients (22.3%) had HbA1C greater than 8. There was no significant correlation noted between elevated HbA1c and increased mortality, need for ICU level of care, hospital length of stay, or need for intubation (P = 0.88, 0.78, 0.22, 0.30 respectively).

Discussion/Conclusion:

Uncontrolled diabetes mellitus and elevated HbA1c levels were suspected to be predictors of poor outcome in COVID-19 infections by many treating physicians. However, our study failed to show this correlation in a sample of 202 patients. Further studies are needed to continue investigation and identify possible predictors of COVID-19 severity in order to appropriately triage and manage these patients.