1Clinical Resident Department of Endocrinology and Diabetology, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia; [email protected]; 2Professor Department of Endocrinology and Diabetology, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia, Head of Endocrinology Department, State Institution "City Hospital No52", Moscow Health Department; 3Candidate of Medicine, Deputy Chief Medical Officer, State Institution "City Hospital No52", Moscow Health Department
Aim: To evaluate the efficiency of glucocorticosteroids (GCS) in combination with biological therapy in the treatment of COVID-19 in patients with type 2 diabetes mellitus (T2D).
Materials and methods: A retrospective study of hospitalized patients with a PCR-confirmed diagnosis of COVID-19 with T2D was conducted (n=179). Patients received standard therapy, including biological preparations. The first group consisted of participants who received GCS (n=46), the second group patients without GCS (n=133). The groups are comparable by sex, age, in severity, of the degree of lung damage according to computed tomography (CT), of the presence of concomitant diseases.
Results: The number of patients transferred to the intensive care unit in the first group was 30.8%, in the second 19.6% (P=0.142), requiring a mechanical ventilation 20.3% and 13.0%, respectively (P=0.378). The proportion of deaths in the first group was 17.4% and in the second 16.5% (P=1.0), the duration of hospital stay was 13 and 11 days, respectively (P=0.001). The median FPG on 7th day in the first group was 8.3 mmol/l, in the second 7.6 mmol/l (P=0.858). The improvement according to CT data in the first group was 10.9%, in the second 16.5% (P=0.475), the weighting was 21.7% and 24.8%, respectively (P=0.674). The level of C-reactive protein in the first group on the 7th day decreased by 52.3 mg/l and in the second by 35.7 mg/l (P=0.110), lactate dehydrogenase increased by 44.7 U/l in the first group and decreased by 18.9 U/l in the second (P=0.743), the content of fibrinogen decreased by 1.7 and 2.5 g/l, respectively (P=0.231), the level of D-dimer didnt change (P=0.996).
Conclusions: The addition of GCS to biological therapy didnt affect the outcomes of COVID-19 in patients with T2D, didnt contribute to a more effective relief of the inflammatory syndrome and a decrease in the degree of lung tissue damage, but prolonged the duration of hospitalization.