Implications of an Hemoglobin A1c (HbA1c)-based Diabetes Screening on Prevalence and Effect of Dysglycemia in Patients With COVID-19
Authors' conclusion
Pandemic conditions may hamper dysglycemia detection rate and in consequence the awareness of individual patient risk for COVID-19 severity. A systematic diabetes screening including HbA1c reduces underdiagnosis of previously unknown or new-onset dysglycemia, and enhances the quality of risk estimation and access of patients at risk to a diabetes-specific intervention.
Study context
- Population
- Non-ICU inpatients with COVID-19, screened at admission for diabetes and prediabetes, November 1, 2020 to March 8, 2021of 601 admitted
- Participants
- 578 inpatients
- Exposure
- Screening with HbA1c, random blood glucose and known history (ABC) vs random blood glucose and known history (BC)
- Outcome
- Dysglycemia rate and effect on COVID-19 outcome
- Follow-up
- Admission
Methodological detailssystematic screening at admission, 2 screening strategies compared (ABC vs BC)
- Systematic screening at admission
- 2 screening strategies compared (ABC vs BC)
Main finding
As reported in the abstract
Prevalence of D (ABC)
38.2%
Prevalence of prediabetes (PreD) (ABC)
37.5%
BC screening failed to identify PreD
96%
206/217
BC screening failed to identify D
26.2%
58/221
Observational data: associations, not effects.
Further findings
D vs normoglycemia: risk of moderate COVID-19 (ABC)
| aOR (95% CI) | ||
|---|---|---|
| D | 2.27 (1.16–4.46) | |
| 0.20.5125Adjusted odds ratio (log scale) |
D: risk of severe COVID-19 (ABC)
| aOR (95% CI) | ||
|---|---|---|
| D | 3.26 (1.56–6.38) | |
| 0.10.31310Adjusted odds ratio (log scale) |
| Outcome | aOR (95% CI) | |
|---|---|---|
| PreDvs normoglycemia: moderate COVID-19 | 1.76 (1.04–2.97) | |
| PreDvs normoglycemia: severe COVID-19 | 2.41 (1.37–4.23) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
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