HbA1C- Biomarker of COVID-19 Severity in Patients with Diabetes Mellitus
Background: Coronavirus Disease 2019 (COVID-19) has affected millions of people worldwide. Diabetes is associated with an enormous health and financial burden. Comorbidity of diabetes and COVID‐19 can lead to poor outcome. Objective: To determine the role of HbA1C as biomarker of COVID-19 severity in patients with diabetes mellitus. Study Design: Cross sectional study. Settings: Chemical Pathology section and COVID ward of Sheikh Zayed Hospital, Rahim Yar Khan Pakistan. Duration: 1st July 2021 to 31st December 2021. Methods: 110 diabetic patients diagnosed with COVID-19 of both genders aged 20-90 years were included in study using consecutive sampling technique. Non diabetics with COVID-19 and patients not willing to be included in the study were excluded. Blood samples were collected for inflammatory markers (C-reactive protein (CRP), Serum ferritin and lactate dehydrogenase (LDH)) and HbA1C. HbA1c was stratified as: <7%, 7%–9% and >9%. Severity of the disease was assessed by requirement of patient for oxygen mask, ventilator or death of the patient. Data was entered and analyzed using SPSS 20. After applying t-test p value <0.05 was taken as significant. Results: 110 diabetic patients hospitalized with COVID-19 were included in the study among which 68 (61.8%) were females and 42 (38.2%) were males. Mean age of the patients was 53.85+14.34 years and majority belonged to middle class. Inflammatory biomarkers serum ferritin, CRP and LDH showed a rising trend with increase in HbA1C. HbA1C was stratified in 3 categories; 21 (19.1%) patients had HbA1C <7%, 53 (48.2%) had HbA1C 7-9% and 36 (32.7%) had >9%. COVID-19 disease outcome was correlated with HbA1C categories and more severe disease was observed in patients with HbA1C >9% (p=0.000). Conclusion: Performing HbA1c test at admission is helpful in diabetics for assessing severity of COVID-19 disease. Special attention should be given to patients with uncontrolled diabetes with vigorous treatment modalities.