Keywords
newly diagnosed type 2 diabetes
inflammatory markers
COVID-19
How to Cite
Abstract
Type 2 diabetes (T2D) remains one of the most common
non-communicable diseases worldwide. Among patients hospitalized
with COVID-19, there is a high proportion of hyperglycemia or
a history of T2D, which increases the risk of severe infection and
complications. Patients with newly diagnosed diabetes require special
attention, as they are at the highest risk group for significant
deterioration and mortality. The aim was to assess the levels of inflammatory
markers in patients with COVID-19 who had newly diagnosed
T2D (ND), pre-existing T2D (PDD), or prediabetes (PD). Material
and methods. A retrospective review of 2.030 medical records
of patients hospitalized with COVID-19 was conducted, of which
150 records were analyzed in more detail. Age, sex, weight, body
mass index, and blood pressure were analyzed. The results of multiple
measurements of fasting blood glucose, glycated hemoglobin
(HbA1c), ketone bodies, blood pH, bicarbonate, C-reactive protein,
D-dimer, ferritin, procalcitonin, creatinine, and lactate dehydroge-nase were studied. Results. Of the 2.030 hospitalized patients, 253
(12.46%) patients had PDD, 34 (1.68%) patients had ND, and another
13 (0.64%) patients had PD. Among patients with ND, 45% were under
60 years of age, of which 20.58% were under 50 years of age. A
trend toward a higher incidence of complications associated with
the underlying COVID-19 disease was observed in patients with ND
compared to patients with PD and PDD: acute respiratory distress
syndrome (26.47% vs. 15.38% and 17.48%, p=0.330), multiple organ
failure syndrome (14.71% vs. 7.69% and 8.74%, p=0.336), and
sepsis (2.94% vs. 0% and 7.77%, p=0.451). Median maximum glucose
levels during hospitalization were significantly higher in patients
with ND compared to patients with PD and PDD (p=0.048).
A statistically significant difference between patients with ND and
PDD concerned the levels of ferritin (985.2 [503–1373] vs. 517.05
[248.75–986.5], p=0.003) and lactate dehydrogenase (420 [295–513]
vs. 288 [235–430], p=0.003) was found. No statistically significant
differences were observed between the median levels of C-reactive
protein (103.94 [58.45–160.84] vs. 86.17 [32.94–165.78], p=0.29) and
D-dimer (1.02 [0.66–3.62] vs. 0.95 [0.51–2.25], p=0.05) in patients
with ND and PDD. Diabetic ketoacidosis was detected in 20.59%
of patients with ND during hospitalization, which was significantly
higher than in patients with PDD. Conclusions. The proportion of
ND among hospitalized patients was 1.68%. Patients with ND had
higher levels of glycemia, markers of inflammation, and tissue damage
(C-reactive protein, ferritin, D-dimer, lactate dehydrogenase),
and a tendency toward more frequent diabetic ketoacidosis compared
to patients with PDD.
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