Risk factors for fatal outcome in patients with type 2 diabetes mellitus and a new coronavirus infection

Маркова, Т. Н.; Anchutina, Anastasia A.; Самсонова, И. В.; Kichigin, V A; Arefyeva, A.N.

doi:10.33029/2304-9529-2022-11-1-8-16

Cited by 10 publications

(4 citation statements)

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“…Субанализ объединенных регистров реальной клинической практики АКТИВ и АКТИВ 2, включающих пациентов амбулаторного и госпитального этапов лечения COVID-19 и 12-месячного наблюдения в постковидном периоде, предназначен для оценки влияния гипергликемии на исходы НКИ. Это связано с особым значением, которое многими исследователями придается НУО у больных с COVID-19 как важнейшему фактору риска развития более тяжелого течения инфекции, а также неблагоприятных исходов [ 1 ][ 7 ][ 9 ][ 3 ].…”

Section: Discussionunclassified

“…Многофакторный анализ показал, что каждое из таких коморбидных состояний, как ИБС, ИМ и инсульт в анамнезе, приводит к существенному увеличению вероятности развития летального исхода в 1,4, в 1,6 и в 2,1 раза соответственно. Интересно, что ожирение, а также АГ, которые, по данным различных исследований, повышали риск наступления летального исхода [ 7 ][ 27 ], в нашем субанализе не демонстрировали самостоятельного влияния, если не были ассоциированы с вышеперечисленными заболеваниями.…”

Section: Discussionunclassified

“…Многочисленные исследования показали, что пациенты с COVID-19 и СД в большей степени нуждаются в госпитализации и проведении неинвазивной кислородотерапии, чаще требуют перевода в отделение интенсивной терапии, проведения искусственной вентиляции легких и характеризуются более высокой летальностью по сравнению с больными без нарушений углеводного обмена (НУО) [ 6 ][ 7 ]. Наряду с этим в реальной клинической практике и по данным публикаций отмечается весьма значительная доля пациентов (~10–60%), у которых в условиях стационара диагностируется впервые выявленная гипергликемия (ВВГ).…”

Section: обоснованиеunclassified

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The impact of carbohydrate metabolism disorders on the early and long-term clinical outcomes of patients with COVID-19 according to the AKTIV and AKTIV 2 registries

Салухов

Arutyunov

Tarlovskaya

et al. 2023

Probl Endokrinol (Mosk)

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BACKGROUND: Numerous studies indicate a high incidence of various disorders of carbohydrate metabolism against the new coronavirus infection. These disorders aggravate the course of infection and increase mortality. Thereby, analysis of risk factors for unfavorable outcomes and assessment of the long-term consequences of COVID-19 in patients with impaired carbohydrate metabolism is of great importance.AIM: To investigate the association between carbohydrate metabolism disorders in COVID-19 patients and mortality, course of infection, long-term consequences, as well as to identify risk factors for an unfavorable disease course.MATERIALS AND METHODS: A retrospective analysis of data from the combined multicenter non-interventional real-world AKTIV and AKTIV 2 registries was performed. The sample included 9290 patients who had COVID-19 with varying severity from June 29, 2020, to November 29, 2020 (AKTIV) and from October 01, 2020, to March 30, 2021 (AKTIV 2). The patients were divided into 3 groups: Group 1 — patients with intact carbohydrate metabolism, n=6606; Group 2 — patients with newly diagnosed hyperglycemia (NDH), n=1073; Group 3 — patients with a history of type 2 diabetes mellitus (DM2), n=1611. The groups were assessed for clinical and laboratory parameters, comorbidities, mortality, carbohydrate metabolic status, and well-being during the infection and at 12 months.RESULTS: The prevalence of carbohydrate metabolism disorders (CMD) was 28,9%, with DM2 patients accounting for 17,3% and patients with newly diagnosed hyperglycemia (NDH) for 11,6%. The mortality rate of patients with hyperglycemia of any origin was 10.6%, which was significantly higher compared to patients without hyperglycemia (3,9%). The probability of lethal outcome increased 2,48-fold in the group of patients with DM2 and 2,04-fold in the group of patients with NDH. At the same time, the probability of a lethal outcome decreased 2,94-fold in patients without CMD. At 12 months, patients with CMD showed a significantly higher frequency and longer persistence of complaints. This trend was more pronounced in patients with DM2 than in those with NDH. Only 1,7% of patients from the NDH group had type 2 diabetes and were receiving oral hypoglycemic medications one year after the infection. A prognostic model was developed to determine the risk of lethal outcome. The model included such known predictors as concomitant ischemic heart disease, history of myocardial infarction or stroke, blood glucose level, and age.CONCLUSION: Carbohydrate metabolism disorders aggravate the course of COVID-19 and increase mortality. One year after infection, patients with DM2 and NDH were more likely to have symptoms typical for post-COVID syndrome, and NDH resolved in most cases after the infection.

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Section: Discussionunclassified

Section: обоснованиеunclassified

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The impact of carbohydrate metabolism disorders on the early and long-term clinical outcomes of patients with COVID-19 according to the AKTIV and AKTIV 2 registries

Салухов

Arutyunov

Tarlovskaya

et al. 2023

Probl Endokrinol (Mosk)

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“…На фоне COVID-19, пациенты с СД продемонстрировали более высокий уровень воспалительного ответа: более высокая концентрация ИЛ-6, С-реактивный белок, ферритина и Д-димера, по сравнению с группой пациентов без СД [1796,1797].…”

Section: наиболее частые варианты коморбидности острых респираторных ...unclassified

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Drapkina,

Kontsevaya,

Kalinina

et al. 2024

Cardiovasc Ther Prev

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Efficacy and safety of glucagon-like peptide-1 receptor agonists therapy initiation in patients with type 2 diabetes hospitalized with coronavirus infection

Markova,

Lysenko,

Stas

et al. 2023

Diabetes mellitus

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BACKGROUND. The search for new effective methods of treatment and prevention of COVID-19 in patients with type 2 diabetes mellitus (T2DM) remains an urgent task for the healthcare system.AIM. To evaluate the efficacy and safety of initiating of glucagon-like peptide-1 receptor agonists (GLP-1RA) therapy in T2DM patients hospitalized with COVID-19.MATERIALS AND METHODS. The inclusion criteria were history of T2DM, BMI> 27 kg/m2, 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. We evaluated the effect of therapy on carbohydrate metabolism, laboratory and clinical parameters, the outcome of COVID-19 and the safety of therapy (hypoglycemic events, side effects).RESULTS. There were no differences found in the degree of decrease in the level of glycemia in the compared groups: fasting plasma glucose (FPG) on day 7 of hospitalization– 8,2 [6,0;9,8] mmol/L vs 8,1 [6,5;9,8] mmol/L (p=0,935), mean daily glycemia (MDG) — 9,7 [8,3;11,8] mmol/L vs 11,1 [8,7;12,8] mmol/L (p=0,182). Therapy of dulaglutide had a positive effect on inflammatory markers: CRP (15,8 vs 24,4 mg/l, p=0,035), LDH (261,6 vs 326,1 U/l, p=0,016) and the level of lymphocytes (1,2 vs 0,9 x 10*9/L, p=0,049) and on clinical parameters: saturation, the need for oxygen therapy and the risk of severe course according to the NEWS2 scale. The death rate in the group receiving GLP-1RA is 3,5 times lower compared to the control group (5,7% vs 20,0%, p=0,038). The initiation of dulaglutide therapy in patients with T2DM hospitalized with COVID-19 reduced the chance of death and transfer to mechanical ventilation by 4,2 times compared to the control group (OR = 0,24, 95% CI: 0,062–0,931). GLP-1RA therapy in patients with COVID-19 and T2DM is safe in terms of hypoglycemic events and side effects.CONCLUSIONS. The initiation of GLP-1RA therapy leads to a decrease in FPG and MDG, comparable with the control group. The start of GLP-1RA therapy in hospitalized patients with COVID-19 and T2DM reduces the chance of death, favorably affecting on laboratory and clinical parameters.

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Risk factors for fatal outcome in patients with type 2 diabetes mellitus and a new coronavirus infection

Cited by 10 publications

References 0 publications

The impact of carbohydrate metabolism disorders on the early and long-term clinical outcomes of patients with COVID-19 according to the AKTIV and AKTIV 2 registries

The impact of carbohydrate metabolism disorders on the early and long-term clinical outcomes of patients with COVID-19 according to the AKTIV and AKTIV 2 registries

Comorbidity of patients with noncommunicable diseases in general practice. Eurasian guidelines

Efficacy and safety of glucagon-like peptide-1 receptor agonists therapy initiation in patients with type 2 diabetes hospitalized with coronavirus infection

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