Endocrine Abstracts

Keywords diabetes, COVID-19, medical care

COVID-19 belongs to the global problem and health systems are faced with severe challenges. Diabetic patients are in the group of risk, especially among elderly people. The aging of the population leads to the comorbidity of diabetic patients with a high risk of death in the case of severe COVID-19 complications. Never doubt it could be fatal for diabetic patients more often than among non-diabetic. Patients with chronic diseases try to avoid visiting medical centers for check-ups or regular tests or consultations concerning social distancing strategies. As a result, a lot of them are hospitalized to COVID departments too late than advisable with severe respiratory disorders. Using glucocorticoids in critically ill patients can lead to decompensation of diabetes which could be potentially life-threatening. We analyzed a group of 393 patients treated in the medical center in Kyiv from September till December of 2020 in 3 infectious departments. Information was received from the database of the clinic, and 100% of patients signed an agreement on using their personal data. No personal data (including name and others) was published. The average duration of in-patient treatment was for 8.78 days. 19 patients died (4.83%). In the group of critically ill diabetes was significantly more often than in the control group. The average duration of treatment was higher in the 1st department due to intensive care wards where were treated critically ill patients. The reason of death was SARS, sepsis, respiratory and heart insufficiency. All of the patients had COVID-19 which was proved laboratory and/or instrumentally (in a small number of cases CT was not performed due to severity of the condition with intensive oxygen supply with higher risks of transportation in the clinic. For such patients, we used ultrasound of lungs for control in dynamics. Some patients reported rapid progression of respiratory insufficiency in the absence of low-grade fever and they tried not to visit a doctor. As a result, the start of intensive care was termed latter. Patients were treated by multiple specialty teams of health professionals including infectionists, internists, anesthesiologists, endocrinologists, specialists in rehabilitation, and sometimes neurologists, cardiologists, nephrologists. It was important to react rapidly in the case of acute kidney injury (including urgent dialysis), acute coronary syndrome (with further stenting of coronary arteries in specialized cardiosurgical centers).

Conclusion

COVID-19 challenges are extremely important for analysis as we are focusing on the improvement of health care.