Clinical and pathogenetic features of coronavirus disease course in type 2 diabetes

Solomiia Mahiiovych; Tetiana Maksymets; Viorika Akimova; Eugen Sklyarov

Solomiia Mahiiovych Department of Therapy No.1, Medical Diagnostics, Hematology and Transfusion FPGE, Lviv, Ukraine
Tetiana Maksymets Department of Therapy No.1, Medical Diagnostics, Hematology and Transfusion FPGE, Lviv, Ukraine
Viorika Akimova Department of Clinical Laboratory Diagnostic, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Eugen Sklyarov Department of Clinical Laboratory Diagnostic, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Keywords: COVID-19, creatinine, dysglycemia, cystatin C

Abstract

A dangerous combination of two diseases that have reached pandemic proportions, COVID-19 and type 2 diabetes, have unique features of the comorbid course. Intense inflammation, hypercoagulation, dysglycemia, and immune and renal dysfunction are underlying processes in the pathogenesis of the combination of these diseases. Our study aimed to compare groups of hospitalized patients with moderate to severe coronavirus disease with and without diabetes, paying particular attention to renal function and examining the relationships between markers of renal dysfunction, inflammation, and thrombosis in these patient groups. In total, 79 patients aged 24 to 73 with moderate to severe coronavirus disease were examined. Patients were divided into 2 groups: 1st – without diabetes; 2nd – with diabetes. The clinical picture, laboratory results (additionally determined cystatin C level) and instrumental studies were compared. Correlation analysis was conducted in groups. The group of patients with type 2 diabetes mellitus had significantly lower oxygen saturation upon admission to the hospital. A significantly higher concentration of glucose in blood serum (11.3 (8.1; 16.5) mmol/l 5.2 (4.4; 6.6) mmol/l, P<0.01) and a lower creatinine level (106.0 (87.3; 123.0) mcmol/l vs. 129.5 (104.8; 167.3) mcmol/l, P<0.05) were observed in the 2nd group while there were no differences in urea and cystatin C levels. By means of correlation matrices, it was established that inflammation, hypercoagulation, dysglycemia, and impaired kidney function are underlying causes of the coronavirus disease pathogenesis in group 1 of patients. At the same time, inflammation and hypercoagulation are the causes in the group of patients with a combined course of type 2 diabetes mellitus. Although the combined course of coronavirus disease and type 2 diabetes mellitus is prognostically more severe, we found a significantly lower creatinine level in the group of patients with type 2 diabetes.