No abstract

Background: Obesity is recognized as a risk factor for adverse outcomes in patients with COVID-19. However, a number of studies, including an analysis of the Federal Registry of Diabetic Patients (Russian Federation), have not identified any significant effect of obesity on mortality in COVID-19. Therefore, the role of obesity, assessed by body mass index (BMI) and waist circumference (WC), as a risk factor for an unfavorable course of coronavirus infection remains disputable. Aim: To assess the impact of obesity on the severity and outcomes of coronavirus infection in the Russian population of hospitalized patients. Materials and methods: This was a single center, retrospective, observational study in 367 patients with the polymerase chain reaction (PCR)-confirmed diagnosis of COVID-19 hospitalized to the in-patient department from April 2020 to November 2021. The first group included 185 patients with obesity (BMI 30.0 kg/m2); the second group consisted of 182 patients without obesity (BMI 30.0 kg/m2). Prevalence of comorbidities, clinical and laboratory parameters, and computed tomography results were assessed in both groups. WC was measured in 100 patients. Results: In this Russian population of hospitalized patients with COVID-19, obesity (BMI 30.0 kg/m2) didn't increase the probability of death both in the general sample (odds ratio (OR) = 1.31; 95% confidence interval (CI) 0.901.92, p = 0.164) and in the patients with type 2 diabetes (OR = 1.0; 95% CI 0.591.7, p = 0.997) or without diabetes (OR = 1.3; 95% CI 0.712.39, p = 0.392). However, obesity was associated with a 1,7-fold increase of the risk of severe COVID-19 (95% CI 1.132.59, p = 0.010). Morbid and abdominal obesity (according to World Health Organization and International Diabetes Federation criteria) had no significant impact on the death rate. WC of 101 cm, regardless of the patients gender, was associated with a 4,9-fold increase of the risk of death (95% CI 1.4516.42, p = 0.012). Conclusion: Obesity didnt show any significant effect on mortality, but increased the chance of severe course of COVID-19 infection. Abdominal obesity (WC 101 cm) was a more significant factor in predicting of a fatal outcome, than BMI.

BACKGRAUND: There is evidence of a multifactorial effect of SARS-CoV2 on carbohydrate metabolism with the development of hyperglycemia and the weighting of COVID19 even in people without DM.AIMS: Assess the prevalence of disorders carbohydrate metabolism (DCM) in hospitalized patients with a new coronavirus infection without a history of DM.MATERIALS AND METHODS: Patients with PCR-confirmed diagnosis of COVID19 aged 18-75 years (n=72) without a history of diabetes were examined. Observation was carried out from the moment of hospitalization to discharge. Patients were collected anamnesis data, laboratory and instrumental studies, HbA1c, fasting plasma glucose (FPG), postprandial glycemia.RESULTS: The prevalence of DCM (HbA1c≥6%) in 72 patients with COVID19 without a history of diabetes admitted to the hospital was 41,7%, while HbA1c ≥6,5% had 8,3%. The median HbA1c in the moderate-flow group was 5,7% [5,3–6,0], and in the severe-flow group it was 6,0% [5,8–6,2] (p=0,008). Participants were divided into groups according to the level of HbA1c≥6% and < 6%. The examined patients showed a high prevalence of risk factors for developing DM: age over 45 years — 83,3%, cardiovascular diseases — 46,3%, obesity — 50%. The study groups didn’t differ statistically in terms of risk factors for DM. In the group with HbA1c≥6%, FPG≥6,1 mmol / l on the second day and postprandial glycemia ≥7,8 mmol/l were observed in more cases than in the group with HbA1c<6% (39,1% vs 12,9%, p=0,051 and 47,8% vs 3,2%, p=0,0001, respectively). The prevalence of DCM in HbA1c was higher than in FPG (41,7% vs 29,2%, p=0,006). On the seventh day, the number of patients with FPG ≥ 6,1 mmol / l in the first group decreased from 39,1% to 4,4% (p=0,01), and in the second group-from 12,9% to 9,7% (p=1,0). There was a direct correlation between the level of HbA1c and C-reactive protein (r=0,271; p=0,048), and an inverse correlation with the content of lymphocytes in the blood (r=-0,25; p=0,068).CONCLUSIONS: In patients with a new coronavirus infection without a history of DM, a high prevalence of DCM was detected — 41,7%. Against the background of comparability of the studied groups by risk factors for DM, an increase in HbA1c, FPG and postprandial glycemia is a manifestation of transient hyperglycemia. Given the high prevalence of DCM, it can be assumed that SARS-CoV2 has diabetogenic properties.

Aim: To determine the impact of initiation of dulaglutide therapy on the course of COVID-19 and the dynamics of inflammatory markers in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods: The inclusion criteria were history of T2DM, BMI &gt; 27 kg/m2, PCR-confirmed diagnosis of COVID-19. The intervention group of 53 patients started dulaglutide therapy (1.5 mg once weekly) during the first 24 hours of admission, the control group consisted of 50 patients, who proceeded with glucose-lowering therapy. In both groups we compared COVID-19 outcomes (mortality/survival rate, ICU admission, need for assisted ventilation) and the duration of hospitalization. On days 3 and 7 of hospitalization we assessed laboratory parameters (FPG, CRP, ALT, AST, LDH, lymphocyte levels, D-dimer). Results: The initiation of dulaglutide therapy reduced the risk of death and transfer to assisted ventilation by 3.5 times in the intervention group compared to the control one (5.7% vs 20.0%, p=0.038). No differences were found in the risk of ICU admission (17.0% vs 28.0%, p=0.18) and the duration of hospitalization (10 bed-days vs 11-bed days, p=0.26). The groups were comparable in respect to carbohydrate metabolic compensation. Compared to those in the control group, patients on dulaglutide therapy demonstrated a lower CRP level (15.8 vs 24.6 mg/L, p=0.035), higher lymphocyte levels (1.2 vs 0.9 × 10*9/L, p=0.049) on day 3 of hospitalization, and a significantly lower LDH concentration level on day 7 (261.6 vs 326.1 U/L, p=0.016). There were no differences in ALT, AST, and D-dimer levels. Conclusion: The initiation of dulaglutide therapy in hospitalized patients with T2DM and COVID-19 decreased the risk of lethal outcomes and transfer to assisted ventilation, as well as proved effective in regards to inflammatory markers (CRP, lymphocytes levels). Disclosure T.Markova: None. M.Stas: None. A.Anchutina: None.