Long-term effects of COVID-19 in diabetic and non-diabetic patients

Alberca, Ricardo Wesley; Ramos, Yasmim Álefe Leuzzi; Pereira, Newton Lindolfo; Beserra, Danielle Rosa; Branco, Anna Cláudia Calvielli Castelo; Orfali, Raquel Leão; Aoki, Valéria; Duarte, Alberto José da Silva; Sato, Maria Notomi

doi:10.3389/fpubh.2022.963834

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…In T2DM, there is an increase in HbA1c and GDP up to 180 days after COVID-19. 48 Several theories of post-COVID-19 hyperglycemia include the pancreas being one of the targets of SARS-CoV2, resulting in focal enlargement of the pancreas or dilatation of the pancreatic duct, resulting in pancreatic injury. 49,46 ACE 2 is thought to be involved in the relationship between COVID-19, hyperglycemia, and pancreatic injury.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

Wahyurini,

Tahapary,

Wibowo

2024

J Indon Med Assoc

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Introduction: Monocytes are very sensitive to changes in the metabolic environment, including hyperglycemia, such as type 2 diabetes mellitus (T2DM). T2DM is characterized by chronic low-grade inflammation and becomes one COVID-19 comorbid. TNF-α and IFN-γ are cytokines often linked to inflammation, the severity of COVID-19, and long COVID-19. This study aims to analyze the relationship between COVID-19 severity and TNF-α and IFN-γ in T2DM one month post-infection.Methods: This research is an experimental study at the Integrated Laboratory Faculty of Medicine, Universitas Indonesia, for four months. The total samples are 44 cryotubes of PBMC (18 T2DM and 26 Non-T2DM) from the CARAMEL study (COVID-19, Aging, and Cardiometabolic Risk Factors). PBMCs were stimulated with inactivated whole virions SARS-CoV-2 and incubated for 24 hours. Monocyte subsets and intracellular cytokines are detected by flow cytometry.Results: Research showed that IFN-γ in the T2DM group was higher in all subsets. There was no significant difference between the T2DM and non-T2DM groups. Based on the history of the severity of COVID-19, MedFI IFN-γ classic and intermediate monocytes differed significantly between the COVID-19 severity groups (p = 0.049 and p = 0.022). Further research is needed to analyze the risk factors involved.Conclusion: MedFI of classic and intermediate monocyte IFN-γ differed significantly between the severity of COVID-19. There were no significant differences between the T2DM and non-T2DM groups. The history of the severity of COVID-19 is significantly related to long COVID-19.

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Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

Wahyurini,

Tahapary,

Wibowo

2024

J Indon Med Assoc

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“…Long term COVID-19 symptoms (so-called long COVID) are present in some patients and are associated to severity of the initial COVID-19 infection ( 38 – 40 ), although inflammatory biomarkers do not seem to be increased 6 months after a COVID-19 infection ( 41 ). However, the association between long COVID and diabetes are not clear, with some studies reporting a significant association ( 42 – 44 ) and others not ( 38 , 40 , 45 , 46 ), with most studies done in patients with a prior COVID-19 hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Risk of severe COVID-19 infection in persons with diabetes during the first and second waves in Denmark: A nationwide cohort study

et al. 2022

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ObjectiveCoronavirus disease-2019 (COVID-19) increases risk of hospitalization and death in diabetes and diabetes-related conditions. We examined the temporal trends in COVID-19-related hospitalization and mortality in the total Danish population by diabetes and diabetes-related conditions in the two first waves of COVID-19 in Denmark.Materials and methodsWe identified all persons with diabetes in the whole Danish population using national registries. COVID-19-related risks of hospitalization and death were assessed using Cox regression analysis in wave 1 (1 March-31 August 2020) and wave 2 (1 September 2020-28 February 2021) of the pandemic for persons with (n=321,933) and without diabetes (n=5,479,755). Analyses were stratified according to status of hypertension, obesity, cardiovascular and microvascular disease.ResultsThe cumulative incidence of COVID-19 hospitalization increased from wave 1 to wave 2 in both persons without (from 4 to 10 in 10,000) and with diabetes (from 16 to 54 per 10,000). The relative risk of hospitalization, however, increased more in patients with diabetes compared to persons without (age-, sex- and co-morbidity-adjusted HR [aHR] 1.40 (95% CI 1.27, 1.55) versus 1.76 (1.65, 1.87), p<0.001 for interaction with wave). The mortality rate, according to the whole population, increased similarly in persons without and with diabetes from wave 1 to wave 2 (from 0.63 to 1.5 versus from 4.3 to 10 in 10,000; aHR 1.65; 1.34, 2.03 and 1.64; 1.43, 1.88). However, when mortality was restricted to the hospitalized population, the crude mortality fell from 26.8% to 19.6% in persons with diabetes, while only a minor decrease was seen in persons without diabetes (from 16.7% to 15.5%).ConclusionThe risk of COVID-19-related hospitalization increased more in persons with than without diabetes from wave 1 to wave 2 of the COVID-19 pandemic in the Danish population. However, mortality according to the whole population did not change, due to reduced mortality among hospitalized persons with diabetes.

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“…Одним из негативных последствий пандемии COVID-19 является повышенный риск развития «новых» и утяжеления ранее имевшихся коморбидных заболеваний в постковидном периоде, что в полной мере относится к патологии углеводного обмена [1]. После инфекции SARS-Cov-2 имеется угроза формирования и/или утяжеления гипергликемии, которая может носить транзиторный характер [2], либо трансформироваться во впервые выявленный сахарный диабет (СД) [3], либо быть следствием декомпенсации сопутствующего СД [2,4].…”

Section: обоснованиеunclassified

Results of a 12-month follow-up of patients with type 2 diabetes mellitus after hospitalization with COVID-19: gliclazide MR use in the hospital and metabolic status at the posthospital stage

et al. 2023

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BACKGROUND: The role of antidiabetic drugs in inpatient with COVID-19 and type 2 diabetes mellitus (T2DM) is usually considered in the context of target glycemiа maintaining. Except for insulin therapy sulfonylurea may be used in moderate COVID-19. The use of original gliclazide MR has advantages due to low risk of hypoglycemia and established cardio- and nephroprotective effects. But it is not clear whether the choice of antidiabetic drugs during hospitalization may affect patient’s condition in post-COVID period.AIM:. To assess the 12-month dynamics of carbohydrate metabolism in patients with T2DM after hospitalization for COVID-19 considering the character of hypoglycemic therapy in the hospital and the use of gliclazide MRMATERIALS AND METHODS: A 12-month prospective study was performed; T2DM patients were observed after hospitalization for COVID-19. They received in hospital: 1) original gliclazide MR (Diabeton MR, n=20) and 2) insulin (control group, n=20). Changes in antidiabetic therapy, glycemic control and biochemical tests were assessed at baseline and after 3, 6, 12 months. RESULTS: In the main and control groups the intensification of T2DM therapy was observed: the proportion of patients without hypoglycemic drugs decreased within a year by 3.0 (p = 0.001) and 2.8 (p =0.010) times respectively. Mean HbA1c values,the dynamics of inflammation markers and transaminases in both groups were similar (p>0.05 at all visits). Blood creatinine was at baseline 82.9±18.67 and 120.9±45.52 µmol/l (p=0.010), after 3 months — 88.0±18.77 and 104, 5±17.99 µmol/l (p=0.024), after 6 months — 89.3±12.17 and 97.5±9.03 µmol/l (p=0.072), after 12 months — 86.7±10.50 and 93.9±16.76 µmol/l (p=0.16). According to the data obtained during «3 months» visit, the dose of original gliclazide MR was directly correlated with the improvement in renal function in terms of glomerular filtration rateGFR (R=0,59, р=0,010). In addition, there was a close-to-significance correlation between continued gliclazide MR at visit 3 and improvement in GFR at visit 6 (R=0.31, p=0.076).CONCLUSION: The post-hospital period in patients with COVID-19 and T2DM was characterized by a tendency to hyperglycemia and increased need for hypoglycemic therapy. The use of original gliclazide MR by in patients with moderate COVID-19 and T2DM is appropriate and safe in terms of clinical and metabolic parameters dynamics during long-term post-hospital follow-up. When original gliclazide MR is continued during the post-hospital period its nephroprotective properties may contribute to the process of renal functions normalization which should be confirmed by further research.

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Long-term effects of COVID-19 in diabetic and non-diabetic patients

Cited by 7 publications

References 22 publications

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

The Impact of COVID-19 Severity on TNF-α and IFN-γ in T2DM Patients' PBMC Monocytes

Risk of severe COVID-19 infection in persons with diabetes during the first and second waves in Denmark: A nationwide cohort study

Results of a 12-month follow-up of patients with type 2 diabetes mellitus after hospitalization with COVID-19: gliclazide MR use in the hospital and metabolic status at the posthospital stage

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