Valeriy Ivanovich Vechorko
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Evgeny Mikhailovich Evsikov
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Oksana Alekseevna Baykova
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Natalya Vadimovna Teplova
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Dmitriy Aleksandrovich Doroshenko
Diabetes mellitus can increase the risk of death in COVID-19 by 12 times, according to the portal of the us Centers for disease control and prevention. Coronavirus-infected diabetics are six times more likely to need inpatient treatment, and diabetes is the second most severe complication in COVID-19 after cardiovascular diseases. The state of carbohydrate metabolism in patients with COVID-19 has not been sufficiently studied in clinical studies. Isolated studies indicate that viral infection may be accompanied by an increase in the concentration of glycated hemoglobin in patients with viral pneumonia. To assess the frequency of hyperglycemia and diagnosis of newly diagnosed diabetes mellitus in patients with COVID-19 and acute lung damage aged 41–80 years, who were hospitalized in a repurposed infectious diseases hospital in Moscow with a diagnosis of pneumonia. In the observational study analyzed laboratory and clinical diagnostic data of 278 patients who had, according to the anamnesis and the medical conclusions of impaired glucose tolerance and manifested forms of diabetes, including 163 men and 115 women, aged 41–80 years, admitted to the hospital for diagnosis and treatment in the period from 12.04.2020 on 10.11.2020 of diagnoses according to ICD-10: U07.1 Coronavirus infection. In the selected groups of patients, the initial and subsequent fasting blood glucose levels were analyzed after 8 hours without food intake on a stationary automatic analyzer and using portable glucose, meters using diagnostic test strips. The concentration of glucose and ketones in the urine was determined by a semi-quantitative method. We evaluated the dynamics of indicators when detecting pathological values of glucose concentration. Glucose levels above 6.4 mmol/l were taken as pathological. In patients aged 41–80 years who were hospitalized with covid-19 infection and pneumonia, fasting hyperglycemia was diagnosed in 31–47%, glucosuria in 1.9–6.1%, ketonuria – 20.4-46.2% of cases, in different age groups. In 16.6–31.3% of cases in patients with covid-19,after treatment and regression of changes in the lungs, normalization of glucose levels was observed, but in 14.8–16.7% of the changes persisted, and in 9–13% of them, after an additional study, newly diagnosed diabetes mellitus was diagnosed. Hyperglycemia was significantly more often detected in patients with arterial hypertension of 2–3 degrees of severity and with a tendency to reliability, in patients with obesity of 2–3 degrees. Lipid metabolism disorders (hypertriglyceridemia and hypercholesterolemia), which are characteristic of changes in carbohydrate metabolism in patients with impaired glucose tolerance and diabetes, were significantly more often diagnosed in patients with covid-19 than in the group of patients with acute and chronic lung pathology without proven infection with this virus, but only in the group of patients aged 41–60 years. Covid-19 infection complicated by pneumonia occurs in individuals aged 41–80 years with a high incidence of hyperglycemia and ketonuria. The incidence of newly diagnosed diabetes mellitus in such patients is 9–13%.
Increased Arterial Stiffness in Prediabetic Subjects Recognized by Hemoglobin A1c with Postprandial Glucose but Not Fasting Glucose Levels
