Metabolic, anthropometric, and functional characteristics of individuals with se vere COVID-19 nearly 20 months after recovery: low physical activity and cardiovascular endurance indicators

Abstract

Diabetes mellitus (DM) and age are associated with increased severity of viral illness and in-hospital mortality in patients with coronavirus disease 2019 (COVID-19). It has also been suggested that COVID-19 and DM may independently or indirectly affect biological age (BA). The aim. Тo evaluate the metabolic, anthropometric and functional characteristics of patients who have recovered from severe forms of COVID-19 and to develop approaches to assess their BA. Material and methods. Рersons who suffered a severe form of COVID-19 with radiologically confirmed pneumonia and were hospitalized in the 4th quarter of 2021 in one of the Kyiv municipal hospitals and were discharged, and persons of the control group without a history of hospitalization due to COVID-19. The documents of 164 patients were processed, 136 of them recovered. During 2023, telephone contact was made with 93 individuals, of whom 29, median age 67 (52-73) years, signed informed consent and were examined according to a program that included a glucose tolerance test, anthropometric measurements, body composition, glycated hemoglobin (HbA1c), functional study of cardiovascular and respiratory systems according to spirometry (FEV 1) and 6-minute walking test (6 MWT). Physical activity (PA) was objectively assessed according to the data of a 7-day actigraphy, which included quantitative assessment of metabolic equivalents of task (MET), moderate-intensity PA (MA) and vigorous PA (VA). Combined tooth attachment loss (AL) was assessed using a graduated periodontal probe (PCP2). The time period from the discharge of patients to the examination at the State Institution «V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine» was 22.0 (21.0-23.0) months, median and QІ-QІІІ, respectively. The control group consisted of 10 people, median age 61.5 (53-69) years, who were not treated for COVID-19 in the hospital. Results. In 10 (34.5%) of the examined patients, DM was known earlier or diagnosed during the course of COVID-19. According to a medical archive analysis (2021), the diagnosis of DM in  hospitalized patients for COVID-19 was associated with elevated levels of procalcitonin, D-dimer, and erythrocyte sedimentation rate. The proportions of newly detected DM (2023) in the COVID-19 group (6 cases, 31.6%) and the control group (1 case, 10%) were not statistically different. The same applies to the category of prediabetes detected by glucose tolerance test. Individuals in the COVID-19 group compared to the control group showed an increase in body mass index (BMI), p=0.022, a decrease in 6 MWT (p=0.007) and PA: MET (p=0.015), MA (p=0.008) and VA (p=0.015). There was a positive correlation between age and body fat percentage, combined AL, systolic blood pressure (SBP), HbA1c and a negative correlation between age and actigraphic measures and 6 MWT results. Conclusions: a study of 29 people with a history of severe COVID-19 found DM in 16 (55.1%) of them. In 34.5% of the studied people DM was diagnosed before or during the COVID-19, which may indicate a more severe course of the disease. However, an increase in newly diagnosed DM almost 2 years after recovery from severe COVID-19 has not yet been found. An increase in potential risk factors for DM (higher BMI, lower PA and functional endurance) was found in this group, comparing to the control. Correlations between age and characteristics of the studied subjects were identified, which can be used to assess BA.