{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:14:05Z","timestamp":1787026445889,"version":"build-2736575974"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u00a0=\u00a02.10, 95% CI: 1.69\u20132.59; I\u00b2 = 45%). The association was stronger in studies with a mean age \u2265 62 years (RR\u00a0=\u00a02.79) compared with &amp;lt; 62 years (RR\u00a0=\u00a01.78;\n                      <jats:italic>p<\/jats:italic>\n                      for subgroup difference = 0.03). Results were consistent across GV metrics, analytic models, adjustment for diabetes status, and study quality (all p &amp;gt; 0.05). Meta-regression analysis showed that mean age demonstrated a borderline association with the effect estimate (coefficient = 0.020,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.07), explaining a moderate proportion of heterogeneity (adjusted R\u00b2 = 49.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher GV is associated with increased short-term mortality in hospitalized patients with COVID-19, supporting its role as a potential prognostic marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420261358246.\n                    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