- In critical care, insulin infusion may help reduce mortality in patients with COVID-19 and hyperglycemia, even in those without diabetes.
Why this matters
- No prior data are available about effects on COVID-19 outcomes of tight glycemic control in patients with hyperglycemia.
- Evaluation of 59 patients hospitalized with moderate (not ventilated) COVID-19.
- On admission, 34 were normoglycemic (≤7.77 mmol/L), of whom 8 had a prior diabetes diagnosis.
- 25 were hyperglycemic (>7.77 mmol/L), including 18 with a diabetes diagnosis.
- Funding: Progetti di Ricerca di Interesse Nazionale.
- Composite endpoint (severe disease, ICU admission, use of mechanical ventilation, or death) occurred in 13 (52%) patients with admission hyperglycemia and 5 (14.7%) with normoglycemia (P<.01>
- Among the 25 patients with hyperglycemia, 15 received insulin infusion (11 with diabetes, 4 without).
- Mean glycemia during hospitalization was 7.69 mmol/L with insulin infusion and 10.65 mmol/L without (P<.001>
- Composite endpoint occurred in 5 (33%) patients with insulin infusion and 8 (80%) without (P<.01>
- In risk-adjusted analysis, mortality risk (HRs) from severe disease through 18 days was significantly lower for:
- No hyperglycemia vs hyperglycemia: 0.285 (P=.044).
- No diabetes vs diabetes: 0.172 (P=.004).
- Mortality risk was increased with no insulin infusion vs having an infusion: 7.542 (P=.027).
- Small sample.