627-P: Uncontrolled Hyperglycemia Predicts Ventilatory Support and Duration of Hospital Stay in People with Diabetes and COVID-19

Background: Despite growing evidence that diabetes is associated with worse COVID-19 outcomes, there remains little information on inpatient glycemic response among individuals with diabetes and uncontrolled hyperglycemia hospitalized with the novel coronavirus SARS-CoV-2.

Methodology: This is a multicentric retrospective study aimed to explore the role of hyperglycaemia (uncontrolled HbA1c) in predicting length of hospital stay and ventilatory support in diabetic patients hospitalised for COVID-19. We excluded all patients with newly diagnosed diabetes within last 3 months and/or those who are only on lifestyle modification.

Results: A total of 133 patient records admitted to three tertiary care hospitals between 15/05/2020 to 15/11/2020 were analysed retrospectively. The 62 patients requiring ventilatory support had a significantly higher HbA1c (9.49±2.73%) as compared to those without ventilatory support (8.09±1.32%), p=0.002. Multiple logistic regression also indicated that the HbA1c was an independent risk factor for ventilatory support in DM patients with COVID-19 (Odds Ratio [OR] = 1.310, 95% confidence interval [CI]: 1.063-1.615), p=0.011. The odds of requiring ventilatory support is 35% lower in patients with good glycemic control (HbA1c<7.5%) vs. those with HbA1c≥7.5% (OR-0.65, 95%CI 0.32-0.88). The mean duration of hospital stay was 10.5±3.45 days. Multiple linear regression analysis revealed HbA1c to predict the duration of hospital stay, p=0.001. For every 1% increase in HbA1c, the length of hospital stay was found to increase by 0.461 days.

Conclusion: The present study demonstrated that a high level of HbA1c was an independent risk factor for ventilatory support and prolonged hospital stay in COVID-19 patients with DM.