Abstract

Usage of HbA1c as a Marker to Assess Progression of COVID-19

Objective: To assess the impact of diabetes on the course of COVID-19 disease in critically ill patients by measuring HbA1c in the first 48 hours of admission and follow-up severity of the disease.

Background: Poor glycemic management has been linked to increased mortality from previous viral pandemics, including H1N1 flu and SARS. Incorporating diabetes status assessment into risk management for COVID-19 patients is currently proposed by many investigations.

Methods: A retrospective cohort study was conducted on 40 critically ill patients during the period from October 2021 to April 2022 on patients admitted to the critical care department in Beni-Suef university hospital. HbA1c was measure at first 48 hours from admission.

Results: This study was conducted on 40 patients. Overall, 50% of the participants were diabetic and 62.5% were hypertensive. There was a significant association between the higher HbA1c level (>8.7) and need to mechanical ventilation, higher length of stay in ICU and the mortality in diabetic patients. The HbA1c had a statistically significant role in prediction of need to MV in diabetic group. At a cut off 8.7, HbA1c can predict the need to MV with 91% sensitivity and 63% specificity in diabetic patients. Likewise, the HbA1c had a statistically significant role in prediction of mortality in diabetic group. At a cut off 8.5, HbA1c can predict the mortality with 90.9% sensitivity and 89% specificity in diabetic patients.

Conclusion: HbA1c has a high sensitivity and acceptable specificity in terms of predicting the mortality in diabetic patients with COVID-19.

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