Influence of metabolic factors on the course of the acute period of COVID-19 in hospitalized patients according to the international registry ACTIV SARS-CoV-2

Alexander Arutyunov; Elizaveta Gordeychuk; Roman Bashkinov; Tatiana Batluk; Evgenii Melnikov; Marina Trubnikova

doi:10.1530/endoabs.90.EP234

EP234

Prev Next

Section Contents Cite

Endocrine Abstracts (2023) 90 EP234 | DOI: 10.1530/endoabs.90.EP234

ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)

Influence of metabolic factors on the course of the acute period of COVID-19 in hospitalized patients according to the international registry ACTIV SARS-CoV-2

Alexander Arutyunov ^1,2 , Elizaveta Gordeychuk ³ , Roman Bashkinov ⁴ , Tatiana Batluk ³ , Evgenii Melnikov ⁴ & Marina Trubnikova ⁵

Err

Author affiliations

¹National Institute of Health after academician S. Avdalbekyan, Erevan, Armenia; ²Eurasian Association of Internal Medicine, "ACTIV SARS-CoV-2" Working Group, Erevan, Armenia; ³Eurasian Association of Internal Medicine, "ACTIV SARS-CoV-2" Working Group, Moscow, Russia; ⁴Eurasian Association of Internal Medicine, "ACTIV SARS-CoV-2" Working Group, Saint Petersburg, Russia; ⁵Eurasian Association of Internal Medicine, "ACTIV SARS-CoV-2" Working Group, Sochi, Russia

Background: The literature shows that body mass index (BMI) and blood glucose levels can significantly influence the course of infectious diseases. In the light of ongoing SARS-CoV-2 pandemic, its rational treatment and prevention are strategic public health goals.

Aim: To study the relationship between BMI and serum glucose levels during the acute period of COVID-19 in hospitalized patients.«ACTIV SARS-CoV-2» registry was established to evaluate the course of COVID-19 in the Eurasian region and covered 7 countries. ACTIV (NCT04492384) and ACTIV 2 (NCT04709120) are multicenter non-interventional real-world registries. 6396 subjects from ACTIV and 2968 subjects from ACTIV 2 were included in this study.

Results: Patients with higher serum glucose levels and BMI had significantly more severe acute period of COVID-19, characterized by acute kidney injury (AKI), hyperinflammatory syndrome, increase in C-reactive protein (CRP) above 100 mg/l, or need for targeted therapy (Table 1). Moreover, hyperglycemia at 6.9 (5.6–9.18) mmol/l was significantly (P<0.001) associated with death in the acute period (versus 5.7 (5.0–7.0) mmol/l in the survivors).

Table 1 Severity of Acute COVID-19 by Serum Glucose Levels and BMI
Characteristics of acute COVID-19	Metabolic factor	Absent Ме (Q1 – Q3)	Present Ме (Q1 – Q3)	P
AKI	Glycemia, mmol/l	5.8 (5.0–7.0)	6.0 (5.2–8.55)	0.011
	BMI, kg/m²	27.8 (24.8–31.6)	29.6 (25.1–33.5)	0.018

“Cytokine storm”	Glycemia, mmol/l	5.7 (5.0–6.6)	6.1 (5.2–8.0)	<0.001
	BMI, kg/m²	27.5 (24.4–31.2)	28.7 (25.6–32.8)	<0.001

CRP above 100 mg/dl	Glycemia, mmol/l	5.4 (4.8–6.7)	6.1 (5.0–8.1)	<0.001
	BMI, kg/m²	27.7 (24.7–31.7)	28.7 (25.5–32.7)	<0.001
Need for targeted therapy	Glycemia, mmol/l	5.8 (5.0–7.1)	6.3 (5.4–8.0)	<0.001
	BMI, kg/m²	27.7 (24.7–31.3)	29.7 (26.3–34.2)	<0.001

Conclusions: Analysis of the ACTIV SARS-CoV-2 registry showed that patients with a more severe course of the acute period of COVID-19 in the form of AKI, “cytokine storm”, increase in CRP above 100 mg/l, or need for targeted therapy had higher serum glucose levels and BMI. In addition, hyperglycemia was associated with death during hospitalization for SARS-CoV-2. These findings allow the studied clinical parameters to be used as characteristics of the severe course of the disease.