Effect of fasting plasma glucose level in severe fever and thrombocytopenia syndrome patients without diabetes

• Published in: PLoS neglected tropical diseases Vol. 18; no. 4; p. e0012125
• Main Authors: Pan, Jun, Yang, Zhihao, Xu, Wen, Tian, Shan, Liu, Xiaobo, Guo, Chunxia
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-04-2024; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Biological markers; Blood Glucose - analysis; Blood sugar; Care and treatment; China - epidemiology; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - mortality; Data collection; Death; Development and progression; Diabetes; Diabetes mellitus; Evaluation; Fasting; Fasting - blood; Female; Fever; Glucose; Health aspects; Hospital Mortality; Hospitals; Humans; Hyperglycemia; Hyperglycemia - complications; Identification and classification; Infections; Infectious diseases; Male; Medical prognosis; Middle Aged; Mortality; Multivariate analysis; Patients; Plasma; Prognosis; Public health; Regression analysis; Retrospective Studies; Risk Factors; SARS-CoV-2; Secondary infection; Severe acute respiratory syndrome; Severe Fever with Thrombocytopenia Syndrome - blood; Severe Fever with Thrombocytopenia Syndrome - virology; Thrombocytopenia; Tick-borne diseases; Variables; Variance analysis; Viral diseases; China
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0012125

Hyperglycemia is correlated with worse in-hospital outcomes in acute infectious diseases such as coronavirus disease 2019 (COVID-19) and severe fever with thrombocytopenia syndrome (SFTS). This study assessed the relationship between fasting plasma glucose (FPG) levels and in-hospital mortality, disease type, and secondary infections among individuals with SFTS without preexisting diabetes. The clinical data and laboratory results upon admission of 560 patients with SFTS without preexisting diabetes meeting the inclusion criteria at Wuhan Union Hospital were collected. FPG levels in surviving patients with SFTS subjects were significantly lower than those in patients with SFTS who had died (P<0.0001). In multivariate Cox regression, high FPG level (≥11.1 mmol/L) was a risk factor independently associated with the in-hospital death of patients with SFTS without preexisting diabetes. Similarly, the FPG levels in general patients with SFTS were significantly lower than those in patients with severe SFTS (P<0.0001). Multivariate logistic regression identified high FPG level (7.0-11.1 mmol/L) as a risk factor independently associated with SFTS severity. While FPG levels were comparable between patients with SFTS with and without secondary infection (P = 0.5521), logistic regression analysis revealed that high FPG levels were not a risk factor for secondary infection in patients with SFTS without preexisting diabetes. High FPG level on admission was an independent predictor of in-hospital death and severe disease in individuals with SFTS without preexisting diabetes. FPG screening upon admission and glycemic control are effective methods for improving the prognosis of patients with SFTS.