Glycosylated hemoglobin as a predictor of mortality in severe pneumonia by COVID-19

ABSTRACT

Objective

Determine whether the levels of glycated hemoglobin (HbA1c) measured on admission to the intensive care unit (ICU) are associated with mortality in patients with severe SARS-CoV-2 pneumonia with invasive mechanical ventilation.

Design

Cohort study, retrospective, observational. A single center.

Place

ICU of a second-level care hospital.

Patients

Severe SARS-CoV-2 pneumonia confirmed with IMV since admission to the ICU.

Interventions

none.

Results

A total of 56 patients with severe pneumonia, confirmed with SARS-CoV-2, all with IMV. The group with HbA1c <6.5% included 32 (57.14%) patients and the group with HbA1c ≥6.5% included 24 (42.86%) patients and the mortality rate in ICU was 43.8% and 70.8%, respectively, with p = 0.04. Predictors of mortality at 28 days in ICU were DHL >500 U/L, OR 3.65 (95% CI 1.18–11.29), HbA1c ≥6.5%, OR 3.12 (95% CI 1.01–9.6), SAH, OR 3.12 (95% CI 1.01–9.5), use of vasopressor, OR 0.2 (95% CI 0.05–0.73), diabetes was not statistically significant.

Conclusion

The 28-day probability of survival in patients with severe SARS-CoV-2 pneumonia with IMV in the ICU is lower when the HbA1c level is ≥6.5% on admission.

KEYWORDS:

• Severe pneumonia
• SARS-CoV-2
• COVID-19
• mechanical ventilation
• glycosylated hemoglobin
• mortality

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

JSSD was responsible for the conceptualization of the study, and the revision and approval of this manuscript. KGPM drafted the manuscript, and was responsible for the accuracy and collection of the data. ORPN and MAGG critically reviewed the paper. All the authors read and approved the final version of the manuscript.

Additional information

Funding

This paper was not funded.