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Comment
. 2021;12(5):6-16.
doi: 10.17691/stm2020.12.5.01. Epub 2020 Oct 28.

COVID-19 in Patients with Diabetes: Clinical Course, Metabolic Status, Inflammation, and Coagulation Disorder

D V Belikina  1 , E S Malysheva  2 , A V Petrov  3 , T A Nekrasova  4 , E S Nekaeva  5 , A E Lavrova  6 , D G Zarubina  7 , K A Atduev  7 , D M Magomedova  7 , L G Strongin  8
Affiliations
Comment

COVID-19 in Patients with Diabetes: Clinical Course, Metabolic Status, Inflammation, and Coagulation Disorder

D V Belikina et al. Sovrem Tekhnologii Med. 2021.

Abstract

The aim of the investigation was to study the clinical course of COVID-19 in the presence of diabetes mellitus (DM) and elucidate possible mechanisms of their mutual aggravation.

Materials and methods: The study included 64 patients with COVID-19; of them, 32 were with DM (main group) and 32 were DM-free (control group). The groups were formed according to the "case-control" principle. During hospitalization, the dynamics of clinical, glycemic, and coagulation parameters, markers of systemic inflammation, as well as kidney and liver functions were monitored and compared.

Results: Among patients with DM, the course of viral pneumonia was more severe, as evidenced by a 2.2-fold higher number of people with extensive (>50%) lung damage (p=0.05), an increased risk of death according to the CURB-65 algorithm (1.3-fold, p=0.043), and a longer duration of insufficient blood oxygen saturation (p=0.0004). With the combination of COVID-19 and DM, hyperglycemia is persistent, without pronounced variability (MAGE - 1.5±0.6 mmol/L), the levels of C-reactive protein (p=0.028), creatinine (p=0.035), and fibrinogen (p=0.013) are higher, manifestations of hypercoagulability persist longer, including slower normalization of antithrombin III (p=0.012), fibrinogen (p=0.037), and D-dimer (p=0.035).

Conclusion: The course of COVID-19 in patients with DM is associated with a high severity and extension of pneumonia, persistent decrease in oxygen supply, high hyperglycemia, accelerated renal dysfunction, systemic inflammation, and hypercoagulability.

Keywords: COVID-19; SARS-CoV-2; diabetes mellitus; glycemia; hypercoagulation; systemic inflammation.

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Figures

Figure 1
Figure 1. Average values of glycemic indices in patients with COVID-19 and diabetes mellitus on days 1 and 2 of hospitalization
Figure 2
Figure 2. Results of continuous glucose monitoring in patient M. (main group)
See this image and copyright information in PMC

Comment on

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