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Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study

There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variabil...

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Autores principales: Hartmann, Bojan, Verket, Marlo, Balfanz, Paul, Hartmann, Niels-Ulrik, Jacobsen, Malte, Brandts, Julia, Dreher, Michael, Kossack, Nils, Häckl, Dennis, Marx, Nikolaus, Müller-Wieland, Dirk
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194894/
https://www.ncbi.nlm.nih.gov/pubmed/35701574
http://dx.doi.org/10.1038/s41598-022-13816-8
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author Hartmann, Bojan
Verket, Marlo
Balfanz, Paul
Hartmann, Niels-Ulrik
Jacobsen, Malte
Brandts, Julia
Dreher, Michael
Kossack, Nils
Häckl, Dennis
Marx, Nikolaus
Müller-Wieland, Dirk
author_facet Hartmann, Bojan
Verket, Marlo
Balfanz, Paul
Hartmann, Niels-Ulrik
Jacobsen, Malte
Brandts, Julia
Dreher, Michael
Kossack, Nils
Häckl, Dennis
Marx, Nikolaus
Müller-Wieland, Dirk
author_sort Hartmann, Bojan
collection PubMed
description There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort study compared several metrics of glycaemic variability for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87–148] mmHg). Continuous HRs showed a proportional increase in mortality risk with daily glycaemic variability (DGV). Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P) < 0.001, LR(P) < 0.001; HR: 1.016, (P) = 0.001, LR(P) < 0.001, respectively). Kaplan–Meier estimators yielded a shorter median survival (25 vs. 87 days) and a higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5 mg/dl (P < 0.0001). High glycaemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, median procalcitonin and FPG.
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spelling pubmed-91948942022-06-16 Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study Hartmann, Bojan Verket, Marlo Balfanz, Paul Hartmann, Niels-Ulrik Jacobsen, Malte Brandts, Julia Dreher, Michael Kossack, Nils Häckl, Dennis Marx, Nikolaus Müller-Wieland, Dirk Sci Rep Article There is high mortality among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS) caused by coronavirus disease (COVID-19). Important factors for COVID-19 mortality are diabetes status and elevated fasting plasma glucose (FPG). However, the effect of glycaemic variability on survival has not been explored in patients with COVID-19 and ARDS. This single-centre cohort study compared several metrics of glycaemic variability for goodness-of-fit in patients requiring mechanical ventilation due to COVID-19 ARDS in the ICU at University Hospital Aachen, Germany. 106 patients had moderate to severe ARDS (P/F ratio median [IQR]: 112 [87–148] mmHg). Continuous HRs showed a proportional increase in mortality risk with daily glycaemic variability (DGV). Multivariable unadjusted and adjusted Cox-models showed a statistically significant difference in mortality for DGV (HR: 1.02, (P) < 0.001, LR(P) < 0.001; HR: 1.016, (P) = 0.001, LR(P) < 0.001, respectively). Kaplan–Meier estimators yielded a shorter median survival (25 vs. 87 days) and a higher likelihood of death (75% vs. 31%) in patients with DGV ≥ 25.5 mg/dl (P < 0.0001). High glycaemic variability during ICU admission is associated with significant increase in all-cause mortality for patients admitted with COVID-19 ARDS to the ICU. This effect persisted even after adjustment for clinically predetermined confounders, including diabetes, median procalcitonin and FPG. Nature Publishing Group UK 2022-06-14 /pmc/articles/PMC9194894/ /pubmed/35701574 http://dx.doi.org/10.1038/s41598-022-13816-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Hartmann, Bojan
Verket, Marlo
Balfanz, Paul
Hartmann, Niels-Ulrik
Jacobsen, Malte
Brandts, Julia
Dreher, Michael
Kossack, Nils
Häckl, Dennis
Marx, Nikolaus
Müller-Wieland, Dirk
Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title_full Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title_fullStr Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title_full_unstemmed Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title_short Glycaemic variability is associated with all-cause mortality in COVID-19 patients with ARDS, a retrospective subcohort study
title_sort glycaemic variability is associated with all-cause mortality in covid-19 patients with ards, a retrospective subcohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9194894/
https://www.ncbi.nlm.nih.gov/pubmed/35701574
http://dx.doi.org/10.1038/s41598-022-13816-8
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