DIABETES MELLITUS TYPE 2 AND METABOLIC ASSOCIATED FATTY LIVER DISEASE IN COVID-19 PATIENTS

Objective. To reveal the features of the course of COVID-19 infection in patients with DM type 2 depending on the density of the liver tissue according to computed tomography (CT).

Materials and methods. The study included 45 patients with DM type 2 and COVID-19. Group 1 included patients with HbAc1 <7.5 % with first-degree obesity, and group 2 with HbA1c >7.5 % and second-degree obesity. All patients underwent assessment of laboratory markers: HbA1c, lipid profile, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, C-reactive protein (CRP), interleukin 6 (IL-6), ferritin, serum iron, parameters of complete blood count, the degree of damage to the lung tissue and the assessment of the densitometric density of the liver tissue were carried out by computed tomography.

Results. In group 1 HbA1c was 7.0 [6.9; 7.3] %, in group 2 it was 8.1 [7.9; 9.5] % (p=0.002). In all the patients severe pneumonia with a decrease in saturation below 95 % was verified. In the comparison groups lymphopenia was detected, more marked in group 2 (11.0 [10.0; 17.0] % vs 9.0 [8.0; 11.0] % in group 1; p=0.039). Group 2 showed an increase in: CRP by 31.8 mg/l (67.2 [41.0; 71.0] mg/l vs 35.4 [27.0; 43.0] mg/l; p=0.016); IL-6 by 16.4 pg/ml (51.8 [42.0; 59.0] pg/ml vs 35.4 [14.5; 53.0] pg/ml; p=0.016); ferritin by 360 ng/ml (710.0 [644.0; 849.0] ng/ml vs 350.0 [321.0; 456.0] ng/mL; p=0.001). Densitometric radiographic density of the liver in group 2 is associated with IL-6 (r=-0.761), CRP (r=-0.652), ferritin (r=-0.745), HbA1c (r=-0.823), SpO2 value (r=-0.823), BMI (r=0.981).

Conclusion. Patients with decompensated DM type 2, second-degree obesity, MAFLD and COVID-19 are characterized by higher rates of HbA1c, IL-6, CRP, transferrin, a decrease in serum iron, lymphopenia and mild anemia, as well as a longer need for humidified oxygen insufflation and greater percentage of lung tissue damage according to CT data.

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Автор(ы): I. P. Dаrаshkevich, T. V. Mokhоrt, M. N. Kurbat, O. N. Martinkevich, E. M. Lukyanchuk, M. V. Ershovа