Endocrine Abstracts

Both hyperglycemia and in-hospital hypoglycemia are associated with poor hospital outcomes and increased healthcare costs. The effect of hypoglycemia may be due to the severity of the infectious disease and the high incidence of comorbidity. The aim of the study was to study the possible relationship between the severity, duration and compensation of hyperglycemia with the course of Covid-19.

Materials and methods: A retrospective analysis of data from primary medical records of 320 patients with Covid-19 infection, who, taking into account their severity of condition, received medical care in the intensive care unit of the infectious hospital in Minsk from June 2020 to March 2022, was carried out. There were 3 groups: 224 people with hospital hyperglycemia – the main group; 51 patients with a history of DM and/or newly diagnosed DM (comparison group); 45 people without glycemic disorders (control group).

Results and discussion: In patients with HH, a more frequent used of tocilizumab and remdisivir, what may indicate a higher severity of the disease course Patients in HH and DM groups showed similar results according to the studied criteria, which confirms the significance of the selected glucose level (more than 7.8 mmol/l) as a threshold for verifying glycemic disorders. In 15.6% of patients with normoglycemia, glycemic levels were less than 4.0 mmol/l. In the present study, lethality in the HH group was the highest and exceeded the control group by 3.5 times, and the indicator of the group with DM by 1.3 times (P<0.001). Comparing glycemia levels was found that in the DM group the glucose value was the highest (7.7 (6.1; 12.9) mmol/l vs. 7.0 (5.9; 8.4) mmol/l in the in HH group). Patients with HH and DM had higher levels of procalcitonin, CRP, LDH, neutrophils, more pronounced lymphopenia, which indicated a more pronounced inflammatory process. The level of D-dimers was also higher in the groups of patients with DM and HH.

Conclusions: According to the study, 70% of patients with severe COVID-19 had newly diagnosed hyperglycemia, 15.6% of patients in the control group had glycemia less than 4.0 mmol/l. The data obtained indicate the need for screening of glycemia and its multiple studies during the day in hospitalized patients with severe COVID-19.