Open AccessThe excess insulin requirement in severe COVID‐19 compared to non‐COVID‐19 viral pneumonitis is related to the severity of respiratory failure and pre‐existing diabetes
Author(s) -
Lockhart Sam M.,
Griffiths Harry,
Petrisor Bogdan,
Usman Ammara,
CalvoLatorre Julia,
Heales Laura,
Bansiya Vishakha,
Mahroof Razeen,
Conway Morris Andrew
Publication year - 2021
Publication title -
endocrinology, diabetes and metabolism
Language(s) - English
Resource type - Journals
ISSN - 2398-9238
DOI - 10.1002/edm2.228
Subject(s) - medicine , covid-19 , pneumonitis , diabetes mellitus , cohort , cohort study , insulin , pneumonia , retrospective cohort study , intensive care medicine , disease , infectious disease (medical specialty) , lung , endocrinology
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.