Type 2 diabetes mellitus in combination with COVID-19: clinical and metabolic characteristics of patients and prediction of mortality risk

BACKGROUND: In the context of the coronavirus pandemic, patients with diabetes are a special risk group. Diabetes mellitus aggravates the disease course. The characterization of comorbidities and the search for available mortality predictors is an urgent problem.

AIM: To assess the clinical and metabolic parameters of comorbidities and determine prognostically significant risk factors for the development of unfavorable outcomes.

MATERIAL AND METHODS: The study included 169 patients with type 2 diabetes mellitus and COVID-19. The patients were divided into two groups: the group 1 included patients who were discharged from the hospital (survivors; n=82), and the group 2 included those who died from COVID-19 (n=87). A comparative assessment of baseline clinical and metabolic parameters in patients of both groups was conducted, and their mortality risk factors were determined.

RESULTS: For several indicators, no statistically significant differences were found between the groups in terms of age, total cholesterol, activated partial thromboplastin time, and fibrinogen. Peculiarities were revealed for other indicators, such as the volume of lung tissue damage, level of oxygen saturation, fasting glycemia, leukocytes, alanine transaminase, aspartate aminotransferase, procalcitonin, ferritin, C-reactive protein, D-dimer, and lymphocytes. Factors that can rapidly predict the risk of death from COVID-19 in patients with type 2 diabetes included saturation <90.12%, area of lung damage >45.8%, and fasting glycemia >7 mmol/L.

CONCLUSION: The results obtained make it possible to assess the condition of patients with type 2 diabetes mellitus and COVID-19, and the identified risk factors of mortality allow the attending physician to form risk groups for patients, conduct constant monitoring, and provide individualized therapeutic measures.