{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T16:51:14Z","timestamp":1781110274078,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Poor outcomes of coronavirus disease 2019 (COVID\u201019) have been linked to diabetes, but its relation to pre\u2010infection glycaemic control is still unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>To address this question, we report here the association between pre\u2010infection Haemoglobin A1c (HbA1c) levels and COVID\u201019 severity as assessed by need for hospitalization in a cohort of 2068 patients with diabetes tested for COVID\u201019 in Leumit Health Services (LHSs), Israel, between 1 February and 30 April 2020. Using the LHS\u2010integrated electronic medical records system, we were able to collect a large amount of clinical information including age, sex, socio\u2010economic status, weight, height, body mass index, HbA1c, prior diagnosis of ischaemic heart disease, depression\/anxiety, schizophrenia, dementia, hypertension, cerebrovascular accident, congestive heart failure, smoking, and chronic lung disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the patients included in the cohort, 183 (8.85%) were diagnosed with COVID\u201019 and 46 were admitted to hospital. More hospitalized patients were female, came from higher socio\u2010economic background and had a higher baseline HbA1c. A prior diagnosis of cerebrovascular accident and chronic lung disease conferred an increased risk of hospitalization but not obesity or smoking status. In a multivariate analysis, controlling for multiple prior clinical conditions, the only parameter associated with a significantly increased risk for hospitalization was HbA1c \u2265 9%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using pre\u2010infection glycaemic control data, we identify HbA1c as a clear predictor of COVID\u201019 severity. Pre\u2010infection risk stratification is crucial to successfully manage this disease, efficiently allocate resources, and minimize the economic and social burden associated with an undiscriminating approach.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dmrr.3398","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T16:03:31Z","timestamp":1598544211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Haemoglobin A1c is a predictor of COVID\u201019 severity in patients with diabetes"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5469-0236","authenticated-orcid":false,"given":"Eugene","family":"Merzon","sequence":"first","affiliation":[{"name":"Medical Division Leumit Health Services  Tel\u2010Aviv Israel"},{"name":"Department of Family Medicine Sackler School of Medicine Tel Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-7152","authenticated-orcid":false,"given":"Ilan","family":"Green","sequence":"additional","affiliation":[{"name":"Medical Division Leumit Health Services  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-6264","authenticated-orcid":false,"given":"Miriam","family":"Shpigelman","sequence":"additional","affiliation":[{"name":"Leumit Health Services Central District Headquarter  Netanya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-7103","authenticated-orcid":false,"given":"Shlomo","family":"Vinker","sequence":"additional","affiliation":[{"name":"Medical Division Leumit Health Services  Tel\u2010Aviv Israel"},{"name":"Department of Family Medicine Sackler School of Medicine Tel Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0209-4453","authenticated-orcid":false,"given":"Itamar","family":"Raz","sequence":"additional","affiliation":[{"name":"The Pesach Segal Israeli Center for Diabetes Research and Policy Sheba Medical Center  Ramat Gan Israel"},{"name":"Diabetes Medical Center  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2406-6402","authenticated-orcid":false,"given":"Avivit","family":"Golan\u2010Cohen","sequence":"additional","affiliation":[{"name":"Medical Division Leumit Health Services  Tel\u2010Aviv Israel"},{"name":"Department of Family Medicine Sackler School of Medicine Tel Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Eldor","sequence":"additional","affiliation":[{"name":"Diabetes Unit Institute of Endocrinology, Metabolism and Hypertension Tel Aviv Sourasky Medical Center  Tel\u2010Aviv Israel"},{"name":"Sackler School of Medicine Tel\u2010Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"e_1_2_8_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.04.018"},{"key":"e_1_2_8_1_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104354"},{"key":"e_1_2_8_1_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3319"},{"key":"e_1_2_8_1_5_1","first-page":"e3360","article-title":"Managing type 2 diabetes mellitus during COVID\u201019 pandemic: the bittersweet","author":"Yehya A","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_8_1_6_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP-2020-0108"},{"key":"e_1_2_8_1_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.0994"},{"key":"e_1_2_8_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.04.006"},{"key":"e_1_2_8_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108185"},{"key":"e_1_2_8_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2020.04.021"},{"key":"e_1_2_8_1_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-4015-1-3"},{"key":"e_1_2_8_1_12_1","unstructured":"TsibelN BadranY BurckL et al.Characterization and classification of geographical units by the socio\u2010economic level of the population. 2015.https:\/\/www.cbs.gov.il\/en\/publications\/Pages\/2019\/Characterization\u2010and\u2010Classification\u2010of\u2010Geographical\u2010Units\u2010by\u2010the\u2010Socio\u2010Economic\u2010Level\u2010of\u2010the\u2010Population\u20102015.aspx. 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