PMID- 38455656
OWN - NLM
STAT- MEDLINE
DCOM- 20240311
LR  - 20240311
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 15
DP  - 2024
TI  - Inflammatory biomarkers predict higher risk of hyperglycemic crises but not 
      outcomes in diabetic patients with COVID-19.
PG  - 1287795
LID - 10.3389/fendo.2024.1287795 [doi]
LID - 1287795
AB  - BACKGROUND: Inflammation is a predictor of severe complications in patients with 
      COVID-19 infection under a variety of clinical settings. A few studies suggested 
      that COVID-19 infection was a trigger of hyperglycemic crises including diabetic 
      ketoacidosis (DKA) and/or hyperglycemic hyperosmolar state (HHS). However, the 
      association between inflammation and hyperglycemic crises in diabetic patients 
      with COVID-19 infection is unclear. METHODS: One hundred and twenty-four patients 
      with type 2 diabetes mellitus (T2DM) and COVID-19 infection from January 2023 to 
      March 2023 were retrospectively analyzed. Demographic, clinical, and laboratory 
      data, especially inflammatory markers including white blood cell (WBC), 
      neutrophils, neutrophil-to-lymphocyte ratio (NLR), c-reactive protein (CRP) and 
      procalcitonin (PCT) were collected and compared between patients with or without 
      DKA and/or HHS. Multivariable logistic regression analysis was conducted to 
      explore the association between inflammatory biomarkers and the prevalence of 
      hyperglycemic crises. Patients were followed up 6 months for outcomes. RESULTS: 
      Among 124 diabetic patients with COVID-19, 9 were diagnosed with DKA or HHS. 
      Comparing COVID-19 without acute diabetic complications (ADC), patients with DKA 
      or HHS showed elevated levels of c-reactive protein (CRP, P=0.0312) and 
      procalcitonin (PCT, P=0.0270). The power of CRP and PCT to discriminate DKA or 
      HHS with the area under the receiver operating characteristics curve (AUROC) were 
      0.723 and 0.794, respectively. Multivariate logistic regression indicated 
      1.95-fold and 1.97-fold increased risk of DKA or HHS with 1-unit increment of CRP 
      and PCT, respectively. However, neither CRP nor PCT could predict poor outcomes 
      in diabetic patients with COVID-19. CONCLUSION: In this small sample size study, 
      we firstly found that elevated serum CRP and PCT levels increased the risk of 
      hyperglycemic crises in T2DM patients with COVID-19 infection. More study is 
      needed to confirm our findings.
CI  - Copyright (c) 2024 Tao, Shu, Wang, Hou, Li, Huang and Hua.
FAU - Tao, Li-Chan
AU  - Tao LC
AD  - Department of Cardiology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
FAU - Shu, Hong
AU  - Shu H
AD  - Department of Endocrinology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
FAU - Wang, Ying
AU  - Wang Y
AD  - Department of Cardiology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
FAU - Hou, Qian
AU  - Hou Q
AD  - Department of Cardiology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
FAU - Li, Jian-Jun
AU  - Li JJ
AD  - State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center 
      for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, China.
FAU - Huang, Xiao-Lin
AU  - Huang XL
AD  - Department of Endocrinology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
FAU - Hua, Fei
AU  - Hua F
AD  - Department of Endocrinology, The Third Affiliated Hospital of Soochow University, 
      Changzhou, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20240215
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 9007-41-4 (C-Reactive Protein)
RN  - 0 (Procalcitonin)
RN  - 0 (Biomarkers)
SB  - IM
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/complications
MH  - *Hyperglycemic Hyperosmolar Nonketotic Coma/diagnosis/epidemiology/etiology
MH  - Retrospective Studies
MH  - C-Reactive Protein
MH  - Procalcitonin
MH  - *COVID-19/complications
MH  - *Diabetic Ketoacidosis/complications
MH  - Biomarkers
MH  - Inflammation/complications
PMC - PMC10919215
OTO - NOTNLM
OT  - C-reactive protein
OT  - diabetic ketoacidosis
OT  - hyperglycemic hyperosmolar state
OT  - procalcitonin
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/03/08 06:43
MHDA- 2024/03/11 06:44
PMCR- 2024/01/01
CRDT- 2024/03/08 04:02
PHST- 2023/09/02 00:00 [received]
PHST- 2024/01/29 00:00 [accepted]
PHST- 2024/03/11 06:44 [medline]
PHST- 2024/03/08 06:43 [pubmed]
PHST- 2024/03/08 04:02 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2024.1287795 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2024 Feb 15;15:1287795. doi: 
      10.3389/fendo.2024.1287795. eCollection 2024.