Stress Hyperglycemia Ratio as a Prognostic Marker in Diabetic Patients Hospitalized with COVID-19

• Published in: Infectious disease reports 2022-09, Vol.14 (5), p.675-685
• Main Authors: Aon, Mohamed, Alsaeedi, Abdullah, Alzafiri, Azeez, Al-Shammari, Abdelrahman, Taha, Sherif, Al-Shammari, Omar, Tawakul, Mahmoud, Alshammari, Jarrah, Alherz, Naser, Alenezi, Monerah, Eyadah, Meshari, Aldhafeeri, Mariam, Alharbi, Teflah, Alshammari, Duaa, Alenezi, Zaid, Aldouseri, Salem, Albazee, Ebraheem, Ibrahim, Mohamed M., Aoun, Ahmed H.
• Format: Article
• Language: English
• Subjects: Comorbidity; Coronaviruses; COVID-19; Diabetes; Diabetes mellitus; Glucose; Hemoglobin; Hospitalization; Hyperglycemia; Laboratories; Markers; Mechanical ventilation; Mortality; Oxygen therapy; Patients; Pneumonia; Respiratory diseases; Risk analysis; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Steroids; stress hyperglycemia ratio; Ventilators
• ISSN: 2036-7449; 2036-7430; 2036-7449
• DOI: 10.3390/idr14050073

Evidence is conflicting about the diabetes characteristics associated with worse outcome among hospitalized COVID-19 patients. We aimed to assess the role of stress hyperglycemia ratio (SHR) as a prognostic marker among them. In our retrospective cohort study, patients were stratified according to SHR, admission glucose, and glycated hemoglobin tertiles. The primary outcome was a composite endpoint of invasive mechanical ventilation, intensive care unit admission, and in-hospital mortality. The study included 395 patients with a mean age of 59 years, and 50.1% were males. Patients in the third tertile of SHR developed more primary events, and the difference was significant compared to the first tertile (p = 0.038) and close to significance compared to the second tertile (p = 0.054). There was no significant difference in the outcomes across admission glucose and glycated hemoglobin tertiles. A higher SHR tertile was an independent risk factor for the primary outcome (OR, 1.364; 95% CI: 1.014–1.836; p = 0.040) after adjustment for other covariables. In hospitalized COVID-19 diabetic patients, SHR third tertile was significantly associated with worse outcome and death. SHR can be a better prognostic marker compared to admission glucose and glycated hemoglobin. A higher SHR was an independent risk factor for worse outcome and in-hospital mortality.