Sam M Lockhart1,2,3, Harry Griffiths3, Bogdan Petrisor3, Ammara Usman3, Julia Calvo-Latorre2, Laura Heales3, Vishakha Bansiya2, Razeen Mahroof3, Andrew Conway Morris3,4. 1. MRC Metabolic Diseases Unit Wellcome Trust-Medical Research Council Institute of Metabolic Science University of Cambridge Cambridge UK. 2. Wolfson Diabetes and Endocrinology Clinic Cambridge University Hospital NHS Foundation Trust Cambridge UK. 3. John Farman Intensive Care Unit Addenbrooke's Hospital Cambridge UK. 4. University Division of Anaesthesia Department of Medicine University of Cambridge Cambridge UK.
Abstract
Introduction: Severe COVID-19 has been anecdotally associated with high insulin requirements. It has been proposed that this may be driven by a direct diabetogenic effect of the virus that is unique to SARS-CoV-2, but evidence to support this is limited. To explore this, we compared insulin requirements in patients with severe COVID-19 and non-COVID-19 viral pneumonitis. Methods: This is a retrospective cohort study of patients with severe COVID-19 admitted to our intensive care unit between March and June 2020. A historical control cohort of non-COVID-19 viral pneumonitis patients was identified from routinely collected audit data. Results: Insulin requirements were similar in patients with COVID-19 and non-COVID-19 viral pneumonitis after adjustment for pre-existing diabetes and severity of respiratory failure. Conclusions: In this single-centre study, we could not find evidence of a unique diabetogenic effect of COVID-19. We suggest that high insulin requirements in this disease relate to its propensity to cause severe respiratory failure in patients with pre-existing metabolic disease.
Introduction: Severe COVID-19 has been anecdotally associated with high insulin requirements. It has been proposed that this may be driven by a direct diabetogenic effect of the virus that is unique to SARS-CoV-2, but evidence to support this is limited. To explore this, we compared insulin requirements in patients with severe COVID-19 and non-COVID-19 viral pneumonitis. Methods: This is a retrospective cohort study of patients with severe COVID-19 admitted to our intensive care unit between March and June 2020. A historical control cohort of non-COVID-19 viral pneumonitispatients was identified from routinely collected audit data. Results:Insulin requirements were similar in patients with COVID-19 and non-COVID-19 viral pneumonitis after adjustment for pre-existing diabetes and severity of respiratory failure. Conclusions: In this single-centre study, we could not find evidence of a unique diabetogenic effect of COVID-19. We suggest that high insulin requirements in this disease relate to its propensity to cause severe respiratory failure in patients with pre-existing metabolic disease.
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