Glycemic variability and the short-term mortality of hospitalized patients with COVID-19: a meta-analysis.

Background: Glucose variability (GV) reflects fluctuations in blood glucose and may better capture metabolic instability than static glycemic measures in patients with Coronavirus disease 2019 (COVID-19). However, its association with mortality remains uncertain due to heterogeneous study designs and inconsistent findings. This meta-analysis was performed to evaluate the association between GV and short-term all-cause mortality in adult patients hospitalized with COVID-19. Methods: PubMed, Embase, and Web of Science were systematically searched for longitudinal observational studies reporting the association between GV and mortality in patients hospitalized with COVID-19. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for the possible influence of heterogeneity. Results: Ten cohort studies comprising 11 datasets and 77,395 patients were included, with 8,189 deaths. High GV was associated with a significantly increased risk of all-cause mortality (RR = 2.10, 95% CI: 1.69-2.59; I² = 45%). The association was stronger in studies with a mean age ≥ 62 years (RR = 2.79) compared with < 62 years (RR = 1.78; Conclusions: Higher GV is associated with increased short-term mortality in hospitalized patients with COVID-19, supporting its role as a potential prognostic marker. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD420261358246.