Diabetes mellitus (DM) can increase the risk of death from COVID-19 by 12 times according to the US Centers for Disease Control and Prevention portal. Patients with diabetes infected with SARS-CoV-2 are 6 times more likely to need hospitalization and inpatient treatment and diabetes is in 2nd place in terms of the severity of complications in COVID-19 after cardiovascular diseases. The state of carbohydrate metabolism in patients with COVID-19 has not been sufficiently studied in clinical studies. In isolated studies, it is noted that infection with the virus may be accompanied by an increase in the concentration of glycated hemoglobin in patients with viral pneumonia.
OBJECTIVE
Estimation of the hyperglycemia incidence and cases of newly diagnosed diabetes mellitus in patients with COVID-19 and acute pulmonary lesions aged 41—80 years hospitalized in a repurposed infectious diseases hospital in Moscow with a diagnosis of pneumonia.
MATERIAL AND METHODS
The observational study analyzed laboratory and clinical diagnostic data of 278 patients (163 men and 115 women) aged 41—80 years who did not have signs of impaired glucose tolerance and manifest diabetes according to the history and medical reports presented. They were admitted to the hospital for diagnosis and treatment in the period from 04/12/2020 to 11/10/2020 with a diagnosis 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 of fasting determined using a stationary automatic analyzer. The concentration of glucose and ketones in urine was determined by a semi-quantitative method. The dynamics of indicators was assessed in identifying pathological values of glucose concentration. The glucose level above 6.1 mmol/L was taken as pathological.
RESULTS
In patients aged 41—80 years hospitalized with a new coronavirus infection and pneumonia, fasting hyperglycemia was diagnosed in 34—51% of cases, glucosuria — in 1.9—6.1%, ketonuria — in 20.4—46.2%. In 63.3—74.3% of cases in patients with COVID-19 after treatment and regression of changes in the lungs the glucose levels were normalized; in 15.4—16.7% of cases the changes persisted; in 9—13% of patients after additional investigation the diabetes was newly diagnosed. Hyperglycemia was detected significantly more often in patients with arterial hypertension of the 2—3rd degree and with a tendency to significance — in patients with obesity of 2—3rd degree. Hypertriglyceridemia, hypercholesterolemia and specific changes in lipid metabolism with impaired glucose tolerance and diabetes were significantly often diagnosed in patients with COVID-19 than in patients with acute and chronic lung pathology without proven infection with SARS-CoV-2 but only in the group of patients aged 41—60.
CONCLUSION
New coronavirus infection complicated by pneumonia occurs in patients aged 41—80 years with a high incidence of hyperglycemia and ketonuria. The incidence of newly diagnosed diabetes mellitus in these patients is 9—13%.
