{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:52:03Z","timestamp":1791996723032,"version":"4.4.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"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. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stress hyperglycemia is a frequent finding in patients with COVID-19 infection and could affect the outcome of disease. Cytokines released in response to infection could have adverse effects on insulin sensitivity and pancreatic beta-cell function. The aim of the study was to examine the relationships of stress hyperglycemia with cytokines and clinical outcomes in hospitalized patients with COVID-19.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a cross-sectional analysis of 150 patients hospitalized for COVID-19 infection who were included in the GIRA-COVID database, we identified patients with stress hyperglycemia by calculation of the Stress Hyperglycemia Ratio (SHR) and use of a cut-off of 1.14. Plasma levels of cytokines principally involved in COVID-19 infection-related cytokine storm were measured. Outcome variables were use of mechanical ventilation and death within 60 days from hospital admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with SHR &amp;gt; 1.14 had significantly higher plasma insulin, HOMA-index, and levels of interleukin-10 (IL-10), interleukin-10\/tumor necrosis factor-a ratio (IL-10\/TNF-\u03b1), and CXC motif chemokine ligand 10 (CXCL10) than patients with SHR \u2264 1.14. IL-10, IL-10\/TNF-\u03b1 ratio, CXCL10, and IFN-\u03b3 were significantly and directly related with SHR in univariate analysis and multivariate logistic regression models showed that IL-10, IL-10\/TNF-\u03b1 ratio, and CXCL10 were independently associated with SHR&amp;gt;1.14. In a multivariate logistic model, stress hyperglycemia predicted use of mechanical ventilation (OR 2.453; CI 1.078\u20136.012) and death (OR 2.281; CI 1.049\u20137.369) independently of diabetes and other major confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients hospitalized for COVID-19 infection, stress hyperglycemia is associated with worse clinical outcomes and is independently related to levels of cytokines that might impair glucose homeostasis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.988686","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T06:52:20Z","timestamp":1660891940000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Relationship between cytokine release and stress hyperglycemia in patients hospitalized with COVID-19 infection"],"prefix":"10.3389","volume":"9","author":[{"given":"Andrea","family":"Da 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