Can HbA1c levels be used as an independent marker of mortality and morbidity risk in patients with COVID19 positive swabs? – a retrospective observational study SARS-CoV-2 and HbA1c

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Mansoor Zafar
Ratan Singh Randhawa
Johannes Hegner
Saba Alam
Mariya Farooq
Reem Eldebri
Bipin Pun
Muhamad Shahbaz
Opeyemi Makanjuola
Frederic Cuison
Dana Safarova
Kamal Lawrence
Amr Elyasaky
Hesam Nooredinvand
Manivannan Periasamy
Lucinda Barry
Alisha Khanna
Karuna Subba
Bolurin Adekunle Adekunle
Oluwamayowa Ojofeitimi
Mohamed Abdelbagi
Andreia Esteves Morete
Giulio Ciroi
Mangala Karkhanis
Bao Khuu
Zahra Maryam
Mirej Patel
Maaryah Zafar
Nadiyah Zafar
Ubaid ur Rehman
Steve Moran
William Alfred ’ O Neill
Abubakr Hadid
Raphael Golez
Tila Muhammad
Mark Whitehead
Umesh Dashora




Diabetes mellitus has shown to be a significant risk factor for patients with coronavirus (SARS-CoV-2). HbA1c levels are often used as marker of poor glycaemic control. We explored whether HbA1c levels could be used as an independent risk factor for mortality and morbidity in patients with positive coronavirus (SARS-CoV-2) swabs.


This was a retrospective, multi-centre study of coronavirus (SARS-CoV-2) swab positive patients who had a recent HbA1c test. Patients were divided into three groups; HbA1c in normal range (group 1), pre-diabetic range (group 2) and diabetic range (group 3). All statistical analysis was done using Stata Version 16 (StataCorp Texas).



A total of 1226 patients had SARS-CoV-2 RNA swabs between 10th February 2020 and 1st May 2020.  A cohort of 120 of these patients had positive swabs and recent HbA1c. Mortality rates for group 1 and 3 were relatively higher than group 2. For mortality assessed by HbA1c as a continuous variable there was significant non-linearity(p=0.001).


HbA1c levels in this study were an independent marker of increased risk of mortality and morbidity in SARS-CoV-2 swab positive patients. Increased comorbidities at normal HbA1c may have contributing role in enhanced mortality.