Evaluation of Triglyceride-Glucose Index as a Marker for Severity in New Onset Diabetes in Patients of COVID-19 Pneumonia- a Single Center Study

Introduction: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV 2) Covid-19 is responsible for the pandemic affecting the world population since 2019. Starting from Wuhan, China enveloped the globe within a few months. It affected the healthy population, but played havoc in terms of mortality and morbidity for old and diseased populations. Diabetes is a known condition putting patients at high risk of complications, resulting from metabolic syndrome-derived impaired immune responses. The world is still grappling with the challenge of managing diabetic patients with covid pneumonia and newly added Diabetics resulting from post covid complications driven by Covid-19-induced damage to pancreatic beta cells. Resulting in worsening of existing Diabetic control and new onset Diabetes (NOD) in susceptible individuals. The TYG (Triglyceride-Glucose Index) may serve as a marker to identify patients at risk of developing a serious illnessHypothesisTriglyceride Glucose Index is a marker for severity of Covid-19 and new onset of diabetes.Aim        To evaluate role of TYG index in prediction of new onset of Diabetes mellitus in Covid-19 patients and as a marker for disease severity in diabetic Covid-19 patients.MethodologyThis cross-sectional study was carried out in Combined Military Hospital (CMH) Rawalakot. Covid-19 patients' diagnosis was confirmed by RT-PCR. Glycosylated hemoglobin (HBA1c), fasting glucose and Triglycerides (TG) were performed at the biochemistry lab using SELECTRA chemical analyzer. TYG index was calculated and related with clinical symptoms of patients.ResultsA total of 2974 samples has been tested by RT-PCR. Three hundred and ninety-three (13%) were positive for COVID-19 infection. Twenty-one patients (5%) developed new-onset Diabetes (NOD) during the COVID infection. A TYG index of 43 people affected with COVID-19 (21 NOD and 22 non-diabetic individuals (control group) was calculated as a marker of severity index. It was found that the higher TYG was associated with severity and mortality in patients with COVID-19 diabetes.                         ConclusionCovid-19 infection is associated with worsening disease in preexisting diabetic patients and is responsible for new-onset Diabetes in patients. TYG index correlates directly with the severity of Covid-19. TYG index can be used as a predictor marker for mortality and morbidity in Covid-19.