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
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).
| 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.
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