Features of COVID-19 course in patients with obesity and dysglycemia

Aim. To study the features of coronavirus disease 2019 (COVID-19) in patients with different severity of carbohydrate metabolism disorders (CMDs), taking into account the possible role of obesity in the acceleration of clinical and laboratory disorders.Material and methods. There were 137 consecutiv...

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Main Authors: L. G. Strongin, K. G. Korneva, A. V. Petrov, T. A. Nekrasova, E. A.A. Mavia, D. V. Belikina, E. S. Malysheva, O. V. Melnichenko
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2022-04-01
Series:Российский кардиологический журнал
Subjects:
Online Access:https://russjcardiol.elpub.ru/jour/article/view/4835
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author L. G. Strongin
K. G. Korneva
A. V. Petrov
T. A. Nekrasova
E. A.A. Mavia
D. V. Belikina
E. S. Malysheva
O. V. Melnichenko
author_facet L. G. Strongin
K. G. Korneva
A. V. Petrov
T. A. Nekrasova
E. A.A. Mavia
D. V. Belikina
E. S. Malysheva
O. V. Melnichenko
author_sort L. G. Strongin
collection DOAJ
description Aim. To study the features of coronavirus disease 2019 (COVID-19) in patients with different severity of carbohydrate metabolism disorders (CMDs), taking into account the possible role of obesity in the acceleration of clinical and laboratory disorders.Material and methods. There were 137 consecutive patients admitted to the infectious disease hospital for COVID-19patients. Three 3 groups were formed: group 1 — 42 patients with concomitant type 2 diabetes (T2D); group 2 — 13 patients with concomitant prediabetes; group 3 — 82 patients without concomitant CMDs.Results. Patients with T2D tended to have a more severe disease course according to the SMRT-CO algorithm (p=0,089), which was associated with the longest hospital stay (p=0,038), the most pronounced (p=0,011) and prolonged (p=0,0001) decrease in oxygen saturation, the maximum percentage of lung injury at the beginning (p=0,094) and at the end (p=0,007) of hospitalization, the greater need for intensive care unit (p=0,050), as well as the highest increase in C-reactive protein and fibrinogen (hypercoagulability and systemic inflammation were noted in all groups). Patients with prediabetes in terms of COVID-19 severity occupied an intermediate position between those with T2D and without CMDs; at the same time, they most often needed the prescription of biological preparations (p=0,001). In the first and second groups, there were larger, compared with the control, proportions of obese people (61,9%, 53,8% and 30,5%, respectively, p=0,003). Prediabetes group had a strong correlation between the severity of viral pneumonitis according to SMRT-CO and the presence of obesity (R=0,69, p=0,009).Conclusion. In patients with impaired carbohydrate metabolism of any severity, COVID-19 is more severe. At the same time, persons with overt T2D are prone to the most severe COVID-19 course, while patients with prediabetes in terms of disease severity occupy an intermediate position between them and those without CMDs. Obesity is a strong risk factor for severe COVID-19 among patients with initial CMDs (prediabetes), which is partly mediated by prior liver dysfunction associated with the metabolic syndrome. The increase in proinflammatory changes and hypercoagulability is associated with COVID-19 severity in patients with and without CMDs. These disorders had the greatest severity and persistence in patients with T2D.
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spelling doaj.art-4a687e8eb302455ca21ad71f00055fac2025-03-02T11:42:57Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202022-04-0127310.15829/1560-4071-2022-48353503Features of COVID-19 course in patients with obesity and dysglycemiaL. G. Strongin0K. G. Korneva1A. V. Petrov2T. A. Nekrasova3E. A.A. Mavia4D. V. Belikina5E. S. Malysheva6O. V. Melnichenko7Privolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityPrivolzhsky Research Medical UniversityAim. To study the features of coronavirus disease 2019 (COVID-19) in patients with different severity of carbohydrate metabolism disorders (CMDs), taking into account the possible role of obesity in the acceleration of clinical and laboratory disorders.Material and methods. There were 137 consecutive patients admitted to the infectious disease hospital for COVID-19patients. Three 3 groups were formed: group 1 — 42 patients with concomitant type 2 diabetes (T2D); group 2 — 13 patients with concomitant prediabetes; group 3 — 82 patients without concomitant CMDs.Results. Patients with T2D tended to have a more severe disease course according to the SMRT-CO algorithm (p=0,089), which was associated with the longest hospital stay (p=0,038), the most pronounced (p=0,011) and prolonged (p=0,0001) decrease in oxygen saturation, the maximum percentage of lung injury at the beginning (p=0,094) and at the end (p=0,007) of hospitalization, the greater need for intensive care unit (p=0,050), as well as the highest increase in C-reactive protein and fibrinogen (hypercoagulability and systemic inflammation were noted in all groups). Patients with prediabetes in terms of COVID-19 severity occupied an intermediate position between those with T2D and without CMDs; at the same time, they most often needed the prescription of biological preparations (p=0,001). In the first and second groups, there were larger, compared with the control, proportions of obese people (61,9%, 53,8% and 30,5%, respectively, p=0,003). Prediabetes group had a strong correlation between the severity of viral pneumonitis according to SMRT-CO and the presence of obesity (R=0,69, p=0,009).Conclusion. In patients with impaired carbohydrate metabolism of any severity, COVID-19 is more severe. At the same time, persons with overt T2D are prone to the most severe COVID-19 course, while patients with prediabetes in terms of disease severity occupy an intermediate position between them and those without CMDs. Obesity is a strong risk factor for severe COVID-19 among patients with initial CMDs (prediabetes), which is partly mediated by prior liver dysfunction associated with the metabolic syndrome. The increase in proinflammatory changes and hypercoagulability is associated with COVID-19 severity in patients with and without CMDs. These disorders had the greatest severity and persistence in patients with T2D.https://russjcardiol.elpub.ru/jour/article/view/4835diabetesprediabetesobesitycovid-19
spellingShingle L. G. Strongin
K. G. Korneva
A. V. Petrov
T. A. Nekrasova
E. A.A. Mavia
D. V. Belikina
E. S. Malysheva
O. V. Melnichenko
Features of COVID-19 course in patients with obesity and dysglycemia
Российский кардиологический журнал
diabetes
prediabetes
obesity
covid-19
title Features of COVID-19 course in patients with obesity and dysglycemia
title_full Features of COVID-19 course in patients with obesity and dysglycemia
title_fullStr Features of COVID-19 course in patients with obesity and dysglycemia
title_full_unstemmed Features of COVID-19 course in patients with obesity and dysglycemia
title_short Features of COVID-19 course in patients with obesity and dysglycemia
title_sort features of covid 19 course in patients with obesity and dysglycemia
topic diabetes
prediabetes
obesity
covid-19
url https://russjcardiol.elpub.ru/jour/article/view/4835
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