Endocrine Abstracts

Recent evidence points to a relationship between the severity of Covid-19 infection and iron metabolism. In patients with type 2 diabetes mellitus (DM 2), the prevalence of anemia of chronic diseases exceeds the general population indicators, which may be one of the factors determining the increase in mortality in this category of patients with Covid-19.

Aim: To determine the differences between markers of ferrostatus indicators in patients with DM 2 and Сovid-19 depending on the value of blood oxygen saturation (SpO2).

Materials and Methods: The study included 84 patients with Covid-19 and DM 2. The levels of glycated hemoglobin (HbA1c), C-reactive protein (CRP), glomerular filtration rate (eGFR), interleukin6 (IL6), ferritin, serum iron (SI), transferrin, soluble transferrin receptors (STR), parameters of a general blood test were determined; SpO2 was assessed; damage to the lung tissue according to computed tomography scan of the lungs was evaluated. All patients we divided into 2 groups. Group 1 included patients with SpO2 ≥ 95%, group 2 - SpO2 < 95%. The comparison groups did not differ in eGFR and HbA1c.

Results: Having analyzed the results of the study the following data were obtained. The data significantly differed between SpO2 values in groups 1 and 2 - 95.0 [95.0; 96.0]% vs 89 [87.0; 91.0]%,(P=0.003). Group 2 had the greatest damage to the lung tissue - 67.2 [65.0; 70.0]% vs 48.3 [40.0; 60.0]%, P=0.001, maximum indices of inflammatory markers CRP (74.8 [69.0; 76.0] vs 45.4 [39.0; 53.0] mg/l, P=0.023, IL6 (64.8 [59.0; 72 .0] vs 38. 2 [14.5; 51.0] pg/ml, р=0.031 and minimal hemoglobin values (110 [101.0; 115.0] g/l vs 119 [108.0;121.0] g/l, P=0.017). The ferrokinetic parameters differed significantly between the comparison groups. Ferritin above the acceptable target values was noted in two groups (in group 2-842.0 [663.0; 942.0] ng/ml vs 350.0 [310.0; 393.0] ng/ml, (P=0.003)). The SI in group 2 was 0.6 [0.5; 0.9] vs 1.1 [0.8; 1.3], P=0.018, the value of transferrin in group 2 was 1.3 [1.2; 2.0] vs 2.1 [1.9; 2.8], P=0.021; STR in group 2 - 1.1 [0.8; 1.3] mg/l vs 1.3 [0.9; 1.4] mg/l in group 1, P=0.041.

Conclusions: In the group of patients with type 2 diabetes and Сovid-19 with SpO2 <89%, the most pronounced disturbances of ferrokinetic parameters were registered, which may be one of the factors determining the more severe course of Сovid-19. STR is within the normal range, which indicates the absence of signs of iron deficiency anemia. Probably, there is a redistribution of iron in the body in patients with DM 2 and Covid-19 infection.