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

Expert Rev Respir Med. 2021 Aug;15(8):1077-1082. doi: 10.1080/17476348.2021.1926988. Epub 2021 May 17.

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: COVID-19; SARS-CoV-2; Severe pneumonia; glycosylated hemoglobin; mechanical ventilation; mortality.

MeSH terms

  • COVID-19*
  • Cohort Studies
  • Glycated Hemoglobin
  • Humans
  • Intensive Care Units
  • Respiration, Artificial
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • Glycated Hemoglobin A