Endocrine Abstracts

Objective: Stress hyperglycemia and decreased control of diabetes mellitus are recorded in severely hospitalized patients and are associated with an increased complications level, length of hospitalization and mortality. Clinical evidence suggests an increased prevalence of hospital hyperglycemia in patients with COVID-19 and a difference from typical stress hyperglycemia.

Materials and methods: We studied 219 moderate and severe hospitalized COVID-19 patients at Minsk City Maternity Hospital N2 in October-November 2021. A retrospective analysis from medical documents was performed.

Examination: Albumin, total calcium, creatinine, alkaline phosphatase, total protein, urea, creatinine, procalcitonin, CRP, total bilirubin, glucose, ALT, AST, ferritin, cretincrinase, uric acid, PCR-test, KT.

Results: All patients were PCR positive, average age 61.1±10.19 years. Patients were hospitalized with moderate or severe COVID-19 pneumonia on days 2–16 of illness. BMI=28.4 (26.3–32.0) kg/m2, glucose=6.1 (5.4–7.3) mmol/l. Type 2 diabetes mellitus was registered in 31 (14.2%) patients; type 1 diabetes mellitus was registered in 3 (1.4%) patients. Hyperglycemia was registered in 163 patients (74.4%), including patients with type 2 diabetes mellitus and type 1 diabetes mellitus. 21 patients with newly reported hyperglycemia (15.9%) had glucose>11.1 mmol/l and basis-bolus insulin therapy was prescribed. Analysis of the medical data of these patients and HbA1c<5.7% indicate that these patients did not have diabetes mellitus before COVID-19. At the end of COVID-19 treatment, 14 (66.7%) patients did not require glucose-lowering treatment.

Conclusion: The results of the study indicate a high prevalence of newly diagnosed hyperglycemia in moderate and severe COVID-19. The identified hyperglycemia in COVID-19 differs from typical stress hyperglycemia and from the manifestation of type 2 diabetes mellitus and type 1 diabetes mellitus and needs further analysis.