Endocrine Abstracts

According to WHO epidemiological data, there are more than 650 million obese people in the world, the medical and social significance of which is determined by the development and aggravation of insulin resistance. Accumulation of experience in the treatment of patients with COVID-19 infection has demonstrated that obesity and diabetes mellitus are important risk factors affecting the clinical severity of inflammatory disease - for impaired function of β-cells along with a cytokine storm and the release of contrainsular hormones.

The aim of the study was to identify phenotypic parameters that affect the prognosis of the course of COVID-19 infection by analyzing data on the features of the manifestation and course of the disease in patients with endocrine and metabolic risks.

Materials and methods: The main group consisted of 15 patients with confirmed COVID-19 infection, a history of type 1 or type 2 diabetes mellitus, or increased fasting glycemia (more than 5.5 mmol/l in capillary blood and 6.1 mmol/l in venous blood) and/or any hyperglycemia (more than 11.1 mmol/l). Comparison group - patients with confirmed COVID-19 infection without dysglycemia. All patients had a severe course of the disease, requiring transfer to the intensive care unit and resuscitation.

Results and discussion: The main group consisted of 7 (47%) men and 8 (53%) women. It was found that in the main group BMI (31.6 (29.0–33.8) vs. 26.0 (24.0–31.0), U=60, P=0.045) and the number of days of hospitalization (17, 6 (14.0–21.1) vs. 14.4 (10.0–18.0), U=67, P=0.033) is significantly higher than in the control group, which confirms overweight and obesity as risk factor for adverse course of COVID-19. Patients with DM have a low percentage of lymphocytes (18.48 (19.0–27.0) vs. 29.0 (16.2–37)%, U=51, P=0.042) and a level of leukocytes (4.6 (3.4–7.9) vs. 5.9 (4.2–9.0) *10⁹/l, U=68, P=0.035), increased levels of C-reactive protein (62.5 (27,0–120.0) vs. 41.0 (22.5–50.9) mg/l, U=69, P=0.045), procalcitonin (0.14 (0.1–0.2) vs. 0.1 (0.08–0.11) ng/ml, U=65, P=0.05) and IL-6 (38.4 (19.0–70.0) vs. 15.0 (9.0–39.0) pg/ml, U=53, P=0.04) compared with patients without diabetes. In the main group of patients, hyperglycemia was first detected in 61.1% of patients, which may indicate COVID-19 as a significant risk factor for the manifestation of DM.

Conclusions: Patients with diabetes have a worse prognosis for COVID-19 due to a complex of associated conditions that increase the risk