An outbreak of COVID-19 has become a global health concern. Although, the epidemiological and clinical characteristics of patients were well documented, understanding of the clinical spectrum of COVID-19 infection is still limited. As a human-to-human transmission disease, a majority of patients have a favorable prognosis, however, there was still with 3.8% crude fatality ratio (CRF) especially in those over 80 years of age [12, 14]. Thus, explore risk factors related to the prognosis would be helpful. In this study, we systematically investigated the effect of FBG on mortality. Our results showed that the death risk was associated with the FBG level at admission, which was not reported elsewhere.
Although epidemiology and the genome had been well elucidated, much remain unknown. The risk factors which influence death are still not clear and until now, there is no specific drug for the treatment of patients with COVID-19 . According to WHO guideline, symptoms of COVID-19 are non-specific and the disease presentation can range from no symptoms (asymptomatic) to severe pneumonia and death. The typical signs and symptoms include: fever, dry cough, fatigue, sputum production, shortness of breath, sore throat, headache, myalgia or arthralgia, chills, nausea or vomiting, nasal congestion, diarrhea, and hemoptysis and conjunctival congestion [7, 8, 16]. These symptoms of mild illness in the early stage of COVID-19 infection may be indistinguishable clinically from many other common infectious diseases. However, in our study, we had observed that the FBG level were also increased (> 6.1 mmol/L) when excluded those with diabetes history. Normal human physiology is dependent on a tight control of the FBG levels. Zhang et al. had revealed that 57/64 diseases showed with increased FBG . Li et al. had reported that patients with FBG ≥ 7.0 mmol/L was one of predictors of all-cause mortality in dilated cardiomyopathy patients . Thus, we believe increased FBG may play an important role in COVID-19 patients’ prognosis.
It is noteworthy that most of our study patients did not diabetes but were still with increased FBG level. Before admitted, they had only treated according to syndrome using lopinavir, ritonavir or arbidol. Without considerate psychological factors, we think increased FBG should raise even more attention in the treatment of COVID-19.
This finding of our study is also consistent with published article. In our study, the average age of death cases was older than those recovered patients, which was in accordance with Chen et al. and [6, 11]. In addition, we had observed a greater number of men than women in the 107 cases of COVID-19 infection.
Although our results might be helpful in COVID-19 prognosis, the results should be considered as preliminary ones and further research is necessary. Some limitations could not be ignored. First of all, due to the limited number of patients, our conclusions need to be further verified by larger samples and multi-center data. And there was only 16 persons died of COVID-19. Secondly, we did not get a dynamic FBG level during the treatment to complete elucidating the important role of blood glucose in the progress of COVID-19. Thirdly, there were not a long-time follow-up to observe whether those with increased FBG patients developed to diabetes or other metabolic disease when they recovery from COVID-19.