Blood glucose is a representative of the clustered indicators of multi-organ injury for predicting mortality of COVID-19 in Wuhan, China

Background: Most patients with Coronavirus Disease 2019 (COVID-19) were mild. Severe patients progressed rapidly to critical condition including multi-organ failure and even death. Identification of early predictive factors is urgently necessary to facilitate appropriate intensive care. Methods: We included all patient admitted to Wuhan Union Hospital and treated by the supportive medical team of Beijing Tongren Hospital as of March 20, 2020. Indicators of injuries for multiple organs, including the heart, kidney and liver, and glucose homeostasis were specifically analyzed for predicting primary outcomes (an intensive care unit (ICU) or death). Findings: The data of 120 patients with a severity equal to or greater than Moderate, discharged from the hospital or died were extracted. After excluding patients with chronic heart, kidney, liver disease and diabetes, 69 patients were included in the final analysis. There were 26 cases with primary outcomes including 16 deaths. Univariable analysis indicated that elevations of fasting blood glucose (FBG), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK) and creatinine (Cr) were associated with higher odds of primary outcomes and more hazards of death. Cox regression results indicated that FBG≥7mmol/L was the only independent predictor for death (HR = 3.75, 95% CI 1.26-11.15). Cluster analysis found more proximities of FBG (at the time of admission) with LDH, HDDH or Creatinine (at the time after 2-4 days of hospitalization) (r=0.43, 0.43 and 0.50, respectively, P