Improving glycemic control may also aid COVID-19 outcomes

(HealthDay)—Insulin infusion helps achieve glycemic targets and may reduce the risk for poor outcomes in patients with hyperglycemia and COVID-19, according to a study published online May 19 in Diabetes Care.

Celestino Sardu, M.D., Ph.D., from University of Campania in Caserta, Italy, and colleagues examined the effects of optimal glycemic control in patients with hyperglycemia and COVID-19. The analysis included 59 patients with COVID-19 hospitalized with moderate disease and admission glycemia >7.77 mmol/L (including 34 normoglycemic and 25 hyperglycemic).

The researchers found that mean glycemia during hospitalization was 10.65 mmol/L in the group not receiving insulin infusion and 7.69 mmol/L in the insulin infusion group. In the hyperglycemic group, at baseline, interleukin-6 and D-dimer levels were significantly higher versus the normoglycemic group. Interleukin-6 and D-dimer levels were persistently higher in patients with hyperglycemia during hospitalization, despite the fact that all patients were on standard treatment for COVID-19 infection. Patients with hyperglycemia and patients with diabetes both had a higher risk for severe disease than those without diabetes and with normoglycemia. Patients with hyperglycemia treated with insulin infusion had a lower risk for severe disease versus patients without insulin infusion.

"Because inflammatory cytokines and procoagulative status have been shown to induce poor outcome in patients with COVID-19, we speculate that optimal glycemic control, by reducing interleukin-6 and D-dimer levels, may reduce the risk of progression of the infectious disease," the authors write.

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