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CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF
CORONAVIRUS INFECTION (COVID-19) DURING DIABETES
MELLITUS
Sadullayeva Rushana Sadullayevna
Bukhara State Medical Institute
https://doi.org/10.5281/zenodo.12730443
Global and domestic data indicate a higher mortality rate in patients with
diabetes mellitus (DM) due to COVID-19, which determines the high relevance of
the analysis of risk factors for adverse disease outcomes in DM to justify the
management tactics of this category of patients.
Objective:
to evaluate the effect of clinical and demographic parameters
(age; gender; div mass index, BMI; glycemic control, HbA1c), as well as
antidiabetic and antihypertensive drugs, including angiotensin converting
enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), on clinical
outcomes (recovery or death) in patients with Type 2 DM (SD2).
Materials and methods
. A retrospective analysis of the database of the
Federal Register of Diabetes Mellitus (RSD) was performed, which included
patients with DM2 (n=309) with pneumonia/COVID-19 and the indicated
disease outcome (recovery/death) in the period from 02/01/2020 to
04/27/2020.
Results.
The mortality rate was 15.2% (47 out of 309 people). It was found
that mortality was significantly higher in males (OR=2.08; 95% CI 1.1−3.9;
p=0.022) and patients on insulin therapy (OR=2.67; 95% CI 1.42−5.02;
p=0.002). Mortality was significantly lower in patients aged less than 65 years
(OR=0.34; 95% CI 0.18−0.67; p=0.001); in patients receiving metformin
(OR=0.26; 95% CI 0.14−0.5; p<0.0001), antihypertensive therapy in general
(OR=0.43; 95% CI 0.22−0.82; p=0.009), beta blockers (OR=0.26; 95% CI
0.08−0.86; p=0.018), diuretics (OR=0.4; 95% CI 0.17−0.93; p=0.028) and
blockers of the renin-angiotensin system (ACE or ARB) (OR=0.36; 95% CI
0.18−0.74; p=0.004). There was a tendency to increase mortality with higher
HbA1c and BMI values, which did not reach statistical significance. Patients
receiving insulin therapy differed from those without insulin therapy by a
significantly longer duration of DM2 (13.4 vs. 6.8 years, p<0.0001), worse
glycemic control in general (HbA1c 8.1 vs. 7.0%, p<0.0001) and 3 times more
frequent failure to achieve the HbA1c goal by more than 2.5% (14.7 vs. 5.9%,
p=0.04).
Conclusion
. The identified risk factors for mortality in patients with DM2
indicate that good glycemic control, previous treatment with metformin and
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
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antihypertensive drugs (including blockers of the renin-angiotensin system) can
reduce the incidence of deaths. Higher mortality on insulin therapy was
associated with poorer glycemic control in this group of patients.
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