Introduction
Although coronavirus disease (COVID-19) caused by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is no longer new, it is still noted as one of the worst pandemics as it has resulted in millions of confirmed infections and deaths. A prior study has described the increased mortality risk observed among COVID-19 patients with diabetes mellitus (DM), wherein blood glucose level is a critical prognostic factor for COVID-19 mortality in patients with and without DM [1]. On the other hand, conflicting data have been reported on HbA1c levels before admission or at admission in relation to COVID-19-related mortality in patients with DM [2]. This study aims to determine the relationship of random plasma glucose (RPG) and HbA1c levels to COVID-19 mortality in hyperglycemic subjects with and without type 2 diabetes (T2D), as well as in normoglycemic subjects with T2D.
Materials and methods
This retrospective observational study with a cross--sectional method was conducted at a central referral hospital in Makassar, Indonesia from July 2020 until the required sample size was met. This study applied the purposive sampling technique, with the population being hyperglycemic and T2D patients who have been treated for COVID-19 infection and the sample size being 100 subjects who met the inclusion criteria. Application for ethical clearance was submitted to the faculty’s Biomedical Research Ethics Committee and approved prior to the study. For the data analysis process, the chi square test was carried out using SPSS version 25; the statistical test result is considered significant if the p value is less than 0.05.
Results
The results are presented in Table 1.
|
Quantity and Percentage |
Variables |
COVID-19 mortality |
Total |
p-value trend |
|
|
Yes |
No |
||||
|
N |
T2D hyperglycemic |
15 |
71 |
86 |
0.015 |
|
N |
Non-T2D hyperglycemic |
4 57,1% |
3 42,9% |
7 100% |
|
|
N |
T2D normoglycemic (RPG < 140mg/dL and HbA1c ≥ 6,5%) |
0 0.0% |
7 100% |
7 100% |
|
|
N |
Total |
19 |
81 81,0% |
100 100% |
|
Discussion
From the correlation of RPG and HbA1c levels to mortality outcomes, the percentage of subjects who died was compared to the percentage of those who survived. In the T2D hyperglycemic variable, 15 subjects died (17.4%), while 71 subjects survived (82.6%). As for the non-T2D hyperglycemic variable, 4 subjects died (57.1%), whereas 3 subjects survived (42.9%). Meanwhile, in the T2D normoglycemic variable, no subject died (0%) and 7 survived (100%). Furthermore, the p-value of = 0.015 (p < 0.05) obtained in the chi-square test signifies a statistically significant relationship between variables. Our results are in line with existing studies, showing that poor blood glucose control in T2D or hyperglycemia is associated with mortality in COVID-19 conditions [3, 4]. Based on the findings above, it can be concluded that there is an association of RPG and HbA1c levels to COVID-19 mortality.
Article information
Funding
None.
Acknowledgments
None.
Conflict of interest
The authors declare that there is no conflict of interest.