Prognostic Value of the Glucose-to-Potassium Ratio for Mortality in Critically Ill COVID-19 Patients

Objectives: Previous studies have demonstrated that an elevated serum glucose-to-potassium ratio (GPR) is associated with poor prognosis in patients with subarachnoid hemorrhage, ischemic stroke, and pulmonary embolism. This study aimed to investigate the association between GPR and mortality among critically ill patients with COVID-19.
Methods: This retrospective study included patients with a confirmed diagnosis of COVID-19 who were admitted to the intensive care unit (ICU) of a tertiary-level hospital between March 2020 and January 2022. Laboratory data and 90-day survival status following ICU admission were recorded. The glucose-to-potassium ratio was calculated for each patient.
Results: The mean GPR was significantly higher in non-survivors than in survivors (45.8±17.0 vs. 38.1±15.1, p=0.006). A significant positive correlation was observed between GPR and mortality (r=0.247, p=0.002). Binary logistic regression analysis identified GPR as an independent risk factor for mortality (odds ratio=1.08, 95% CI 1.03–1.14, p=0.002). Receiver operating characteristic (ROC) analysis determined a GPR cut-off value of >32.1, yielding a sensitivity of 81.9% and specificity of 50.0% (AUC=0.647, 95% CI 0.565–0.723, p=0.002). The prevalence of kidney disease as a comorbidity was significantly higher among non-survivors (p=0.009).
Conclusion: Elevated glucose-to-potassium ratio and the presence of kidney disease at the time of ICU admission are associated with poor prognosis in patients with COVID-19.

Keywords: COVID-19, glucose, intensive care unit, potassium, mortality