Chromatography Identifies Undiagnosed Diabetes in COVID-19 Patients

Since a small cluster of patients with a new virus emerged in China, a global pandemic has been declared by the World Health Organization. The impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease coronavirus disease 2019 (Covid-19) has been felt globally. Whole economies are suffering as many countries lockdown and restrict the movement and interaction of people to try and contain the spread of the virus and the disease it can cause.

An Austrian story

For some groups of people, the impacts of the virus and disease can be more severe. People with underlying health conditions and older people are at greater risk if they contract the disease. As are people with diabetes. Currently, the evidence suggests that people with diabetes are not more likely to get Covid-19 than the general population. But, if you have diabetes and you get Covid-19, the health outcomes could be worse with a greater risk of complications and death than people without diabetes.

A recent paper published in the journal Critical Care reports on work carried out by researchers in Austria that suggests it might be advantageous to analyse all hospitalized Covid-19 patients for diabetes. The researchers at the Medical University Innsbruck retrospectively analysed the incidence of diabetes in patients admitted to intensive care units at the University Hospital in Innsbruck, Austria.

Swabs and Hb analysis

Patients were included in the study if they were over 18 and had a confirmed diagnosis of Covid-19 from a reverse-transcriptase-polymerase-chain-reaction assay of a nasal/throat swab. 47 patients were admitted to the ICUs, and of those 44 also had their glycated haemoglobin (HbA1c) analysed using high-performance liquid chromatography (HPLC-UV/Vis). Advances in the use of HPLC are discussed in the article, The Theory and Advantages of Solid-Core Particles. HbA1c is the average blood glucose level for the past 2-3 months and is an indicator of whether you have diabetes or are at risk of getting diabetes.

Chromatography spots hidden diabetes

Of the patients included in the study, only 16% had a medical history of diabetes. But according to the results of the HbA1c tests, 24 patients were considered to have diabetes and 16 were in a pre-diabetes condition and at risk of getting diabetes. Patients with increased HbA1c levels were found to have increased levels of inflammation markers like IL-6 and CRP and there was a trend to higher mortality levels with increased HbA1c.

The researchers conclude that 85% of Covid-19 patients they treated in the ICUs had prediabetes and diabetes and that these conditions appeared to be factors for more severe complications in Covid-19 cases. The recommend routine measurement of HbA1c in hospitalized patients, even if they have no pre-existing diabetes diagnosis.