Endocrine Abstracts

Objectives: The novel coronavirus disease-2019 (COVID-19) is the fastest-spreading disease worldwide, with over 380 million cases and 5 million deaths. The presence of diabetes mellitus (DM) in patients with COVID-19 was associated with mortality, acute respiratory distress syndrome, disease progression. COVID-19 was progressed with some hematological disorders, especially lymphopenia. Studies implicated that neutrophil-to-lymphocyte ratio (NLR) level can be a reliable marker in showing the severity of COVID-19 disease. A routine hematology analyzer measures the percentage of large unstained cells (%LUCs), reflecting activated lymphocytes and peroxidase-negative cells. In previous studies, the%LUCs was found to be associated with disease progression in patients with HIV. This study aims to investigate whether the%LUCs and NLR parameters are associated with disease progression in diabetic patients with COVID-19.

Materials and Methods: The data of the patients hospitalized in the Infectious Diseases Service and Intensive Care Unit with a COVID-19 in Ankara City Hospital between 15.03.2020 and 15.07.2020 were collected in our retrospective study. This study included 656 patients with COVID-19, 131 with DM, and 525 with the DM-free control group. White blood cell (WBC) count, neutrophils, neutrophil percentage, lymphocytes, lymphocyte percentage, LUCs,%LUCs, NLR, platelets, hemoglobin which was taken within the first 24 hours after admission, and history of DM were noted from the records.

Results: The mean age was 61.29±13.81 years in the diabetic patient group and 44.37±17.14 years in the non-diabetic control group with COVID-19, which was significantly higher in the diabetic group (P<0.001). NLR, WBC count, neutrophils, and neutrophil percentage were statistically significantly higher in patients with DM (respectively, P<0.001, P=0.008, P=0.008, P=0.003, and P=0.049). There were no significant differences between the groups regarding lymphocyte, platelet, LUCs, and%LUCs values (P>0.05).

Conclusion: There are studies in the literature that a decrease in%LUCs value and an increase in NLR are indicators of severe disease in COVID-19. Our study did not detect a difference in%LUCs value in diabetic patients, but our study is a preliminary study. Analysis of the data with clinics continues with more patients.

Keywords: COVID-19, Diabetes Mellitus, neutrophil-to-lymphocyte ratio, large unstained cells