PMC:7347402 / 2187-4961 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7347402","sourcedb":"PMC","sourceid":"7347402","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7347402","text":"Introduction\nSince December 2019, a pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dubbed coronavirus disease 2019 (COVID-19) hit Wuhan, Hubei province, China [1]. As the infection quickly spread around the globe to an alarming level, the WHO unprecedentedly declared a pandemic on 11 March 2020 [2]. As of 6 June 2020, the number of affected countries and regions has soared to 216, with more than 6,600,000 cases of COVID-19 confirmed worldwide [3]. A total of 392,000 patients have died of COVID-19, according to the WHO [3]. The crude fatality ratio (CFR) stood at 5.9% as of 6 June 2020 [3], whereas, at the inception of the outbreak, the overall CFR was 17.3%, as reported by the WHO–China joint mission [1], and even moderately ill patients may progress to death [1]. Therefore, it is crucial to assess the prognosis of the illness early and start intervention promptly.\nAs we know, diabetes is an established risk factor for significantly elevated mortality rates in a wide array of acute or chronic diseases, such as cardiovascular diseases, cerebrovascular diseases, cancer and infections due to poor glycaemic control and chronic hyperglycaemic state [4–7]. In addition, one study showed that fasting hyperglycaemia was strongly correlated with mortality in patients with or without diabetes [7]. Evidence indicated that a chronic hyperglycaemic state was associated with impaired immunity [6] and hyperglycaemia is an independent predictor for lower respiratory tract infection and poor prognosis [6, 8–10]. In particular, a few previous studies have shown that hyperglycaemia was a risk factor for high morbidity and mortality from severe acute respiratory syndrome (SARS) [11] and Middle East respiratory syndrome (MERS) [12].\nRecently, a descriptive study suggested that diabetes and/or acute uncontrolled hyperglycaemia (defined as blood glucose measurements \u003e10 mmol/l twice within any 24 h period) were associated with an increased length of hospital stay and higher mortality due to COVID-19 [13]. Furthermore, well-controlled blood glucose (glycaemic variability within 3.9–10.0 mmol/l) was reportedly associated with markedly lower mortality compared with individuals with poorly controlled blood glucose (upper limit of glycaemic variability exceeding 10.0 mmol/l) in patients with pre-existing type 2 diabetes during hospitalisation for COVID-19 [14]. However, direct correlation between fasting blood glucose (FBG) level at admission and clinical outcomes of COVID-19 patients without diagnosed diabetes has not been well established. Therefore, in this study, we examined the association between FBG on admission and the 28-day mortality of COVID-19 patients without previously diagnosed diabetes in two 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