145-LB: Glycemic Control Is Not an Independent Predictor of Mortality or Length of Stay for Patients Hospitalized with Coronavirus 2019 (COVID-19)

Diabetes mellitus (DM) is an important prognostic factor for coronavirus 2019 (COVID-19). However, studies of hospital glycemic control and outcomes controlled for factors that affect morbidity and mortality in pneumonia (PNA) are limited. We conducted a multicenter retrospective cohort study of patients ≥ 18 years (N=108) admitted to either the ICU or noncritical units January 1, 2020 to September 29, 2020 with a clinical diagnosis or radiographic evidence of PNA, laboratory confirmation of COVID-19, and DM or newly diagnosed hyperglycemia, defined as admission plasma glucose > 126 mg/dL or one or more random plasma glucose measurements > 200 mg/dL. Co-primary endpoints were mortality, ICU length of stay (LOS), and total hospital LOS stratified by mean capillary blood glucose (CBG) for hospitalization. Endpoints were compared by logistic, linear, or Poisson regressions controlling for demographic variables, prehospital HbA1c, residence, pneumonia severity index score, Sequential Organ Failure Assessment score (ICU patients), pulmonary consultation, infectious diseases consultation, and study site. Patients treated with dexamethasone (N=42) were evaluated separately from untreated patients. There was no difference in mortality for patients with mean hospital CBG < 180 mg/dL (30.1%) or ≥ 180 mg/dL (20.0%, P=0.24). Median total hospital LOS was 8 (5-15) and 8 (6-16) days for patients with mean CBG < 180 mg/dL or ≥ 180 mg/dL, respectively (P=0.35), and there was no difference in ICU LOS by glycemic status (P=0.19). No measures of glycemic control were independent predictors of mortality or LOS in multivariable regression analyses, and results were unaffected by dexamethasone treatment status. In this study controlling for multiple validated PNA prognostic factors, hospital glycemic control did not have a significant effect on mortality or LOS for patients with DM or newly diagnosed hyperglycemia hospitalized with COVID-19.1`