Research Article
BibTex RIS Cite

The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients

Year 2025, Volume: 5 Issue: 4, 134 - 139, 13.11.2025
https://doi.org/10.56016/dahudermj.1797274

Abstract

Objectives: The association of COVID-19 with metabolic risk factors is a critical issue influencing disease progression and mortality. The triglyceride-glucose (TyG) index, a practical indicator of insulin resistance, holds value in the prognosis of cardiovascular diseases. In this study, we aimed to inves-tigate the relationship of the TyG index with demographic characteristics, clinical findings, labora-tory parameters, and mortality in patients admitted to the intensive care unit (ICU) due to COVID-19.
Methods: Between November 2021 and April 2022, a retrospective cross-sectional design was employed to include 88 COVID-19-positive patients with CO-RADS scores of 3 or higher admitted to a tertiary-level ICU. Demographic data, comorbidities, symptoms, laboratory results, thoracic computed tomography (CT) findings, and clinical outcomes were recorded. The TyG index was calculated using the formula Ln[triglyceride (mg/dL) × glucose (mg/dL)/2]. Statistical analyses utilized pa-rametric and nonparametric tests, with significance set at p<0.05.
Results: The mean age of the patients was 74.6±12.9 years, with 54.5% being male. The average TyG index was 4.95±0.35. The TyG index was significantly higher in patients with a history of diabetes melli-tus and cardiovascular disease (p=0.030 and p=0.035). The TyG value was higher in the presence of fever (p=0.033). The mortality rate was 53.4%, but no direct relationship was observed between TyG and mortality. Logistic regression analysis revealed no independent association between the TyG index and mortality (OR=1.32; 95% CI=0.61-2.87; p=0.478). While intubation, vasopressor use, septicemia, and oxygen saturation <90% were significantly associated with mortality, no sig-nificant relationship was found with TyG.
Conclusion: The TyG index appears to be associated with metabolic comorbidities and inflammatory markers in COVID-19 ICU patients; however, it is insufficient as an independent marker for mortality pre-diction. Largerscale studies are required.

Ethical Statement

Ethical approval was obtained from the Non-Interventional Clinical Research Ethics Committee of Eskisehir Osmangazi University (Decision No: 32, 26/7/2022).

References

  • 1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. doi:10.1016/S0140-6736(20)30566-3.
  • 2. Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endo-crinol. 2020;8(9):782-92. doi:10.1016/S2213-8587(20)30238-2.
  • 3. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity: comparison with the euglycemichyperinsulinemic clamp. J Clin Endocrinol Metab. 2010;95(7):3347-51. doi:10.1210/jc.2010-0288.
  • 4. Liu Q, Zhang Y, Chen S, Xiang H, Ouyang J, Liu H, et al. Association of the triglyceride-glucose index with all-cause and cardiovascular mortality in patients with cardiometabolic syndrome: a national cohort study. Cardiov Diabetol. 2024;23(1):80. doi:10.1186/s12933-024-02152-y.
  • 5. Ren H, Yang Y, Wang F, Yan Y, Shi X, Dong K, et al. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiov Diabetol. 2020;19(1):58. doi:10.1186/s12933-020-01035-2.
  • 6. Biter HI, Kalyoncuoğlu M, Tosu AR, Çakal S, Apaydın Z, Gümüşdağ A, et al. Prognostic value of the TyG index for in-hospital mortality in nondiabetic COVID-19 patients with myocardial injury. Rev Assoc Med Bras (1992). 2022;68(9):1297-302. doi:10.1590/1806-9282.20220410.
  • 7. Chang Y, Jeon J, Song TJ, Kim J. Association of triglyceride-glucose index with prognosis of COVID-19: a population-based study. J Infect Public Health. 2022;15(8):837-44. doi:10.1016/j.jiph.2022.06.014.
  • 8. Sharifi-Zahabi E, Nasiri N, Hajizadeh-Sharafabad F, Sharifi M, Saber A. Triglyceride–glucose index and the risk of in-hospital and ICU all-cause mortality: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2025;15(1):8. doi:10.1038/s41387-025-00366-x.
  • 9. Prokop M, van Everdingen W, van Rees Vellinga T, Quarles van Ufford H, Stöger L, Beenen L, et al. CO-RADS: a categorical CT assessment scheme for patients suspected of having COVID-19: definition and evaluation. Radiology. 2020;296(2):E97-E104. doi:10.1148/radiol.2020201473.
  • 10. Xu H, Mo R, Liu Y, Niu H, Cai X, He P. L-shaped association between triglyceride-glucose body mass index and short-term mortality in ICU patients with sepsisassociated acute kidney injury. Front Med (Lausanne). 2024;11:1500995. doi:10.3389/fmed.2024.1500995.
  • 11. Huang X, Cheng H, Yuan S, Ling Y, Tan S, Tang Y, et al. Triglyceride-glucose index as a valua-ble predictor for aged 65-years and above in critical delirium patients: evidence from a multi-center study. BMC Geriatr. 2023;23(1):701. doi:10.1186/s12877-023-04420-0.
  • 12. Hu Y, Zhao Y, Zhang J, Li C. The association between triglyceride glucose-body mass index and all-cause mortality in critically ill patients with atrial fibrillation: a retrospective study from MIMIC-IV database. Cardiovasc Diabetol. 2024;23(1):64. doi:10.1186/s12933-024-02153-x.
  • 13. Rohani-Rasaf M, Mirjalili K, Vatannejad A, Teimouri M. Are lipid ratios and triglyceride-glucose index associated with critical care outcomes in COVID-19 patients? PLoS One. 2022;17(8):e0272000. doi:10.1371/journal.pone.0272000.
  • 14. Liu D, Ren B, Tian Y, Chang Z, Zou T. Association of the TyG index with prognosis in surgical intensive care patients: data from the MIMIC-IV. Cardiovasc Diabetol. 2024;23(1):193. doi:10.1186/s12933-024-02293-0.
  • 15. Zheng R, Qian S, Shi Y, Lou C, Xu H, Pan J. Association between triglyceride-glucose index and in-hospital mortality in critically ill patients with sepsis: analysis of the MIMIC-IV data-base. Cardiovasc Diabetol. 2023;22(1):307. doi:10.1186/s12933-023-02041-w.
  • 16. Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al. Risk factors associ-ated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345-55. doi:10.1001/jamainternmed.2020.3539.
  • 17. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):486-552. doi:10.1097/CCM.0000000000002255.
  • 18. De Vita N, Scotti L, Cammarota G, Racca F, Pissaia C, Maestrone C, et al. Predictors of intu-bation in COVID-19 patients treated with out-of-ICU continuous positive airway pressure. Pulmonology. 2022;28(3):173-80. doi:10.1016/j.pulmoe.2020.12.010.
There are 18 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Articles
Authors

Sevilay Süreyya Ermis 0000-0003-4061-6670

Zeynep Irmak Kaya 0000-0002-3954-1985

Alaettin Ünsal 0000-0001-8353-1605

Early Pub Date November 11, 2025
Publication Date November 13, 2025
Submission Date October 5, 2025
Acceptance Date November 10, 2025
Published in Issue Year 2025 Volume: 5 Issue: 4

Cite

APA Ermis, S. S., Irmak Kaya, Z., & Ünsal, A. (2025). The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients. DAHUDER Medical Journal, 5(4), 134-139. https://doi.org/10.56016/dahudermj.1797274
AMA Ermis SS, Irmak Kaya Z, Ünsal A. The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients. DAHUDER MJ. November 2025;5(4):134-139. doi:10.56016/dahudermj.1797274
Chicago Ermis, Sevilay Süreyya, Zeynep Irmak Kaya, and Alaettin Ünsal. “The Association of Triglyceride-Glucose (TyG) Index With Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients”. DAHUDER Medical Journal 5, no. 4 (November 2025): 134-39. https://doi.org/10.56016/dahudermj.1797274.
EndNote Ermis SS, Irmak Kaya Z, Ünsal A (November 1, 2025) The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients. DAHUDER Medical Journal 5 4 134–139.
IEEE S. S. Ermis, Z. Irmak Kaya, and A. Ünsal, “The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients”, DAHUDER MJ, vol. 5, no. 4, pp. 134–139, 2025, doi: 10.56016/dahudermj.1797274.
ISNAD Ermis, Sevilay Süreyya et al. “The Association of Triglyceride-Glucose (TyG) Index With Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients”. DAHUDER Medical Journal 5/4 (November2025), 134-139. https://doi.org/10.56016/dahudermj.1797274.
JAMA Ermis SS, Irmak Kaya Z, Ünsal A. The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients. DAHUDER MJ. 2025;5:134–139.
MLA Ermis, Sevilay Süreyya et al. “The Association of Triglyceride-Glucose (TyG) Index With Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients”. DAHUDER Medical Journal, vol. 5, no. 4, 2025, pp. 134-9, doi:10.56016/dahudermj.1797274.
Vancouver Ermis SS, Irmak Kaya Z, Ünsal A. The Association of Triglyceride-Glucose (TyG) Index with Clinical Findings and Outcomes in COVID-19 Intensive Care Unit Patients. DAHUDER MJ. 2025;5(4):134-9.

INDEXING & ABSTRACTING & ARCHIVING

        35061


DAHUDER Medical Journal, hosted by Turkish JournalPark ACADEMIC, is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

35194