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Multiplex analysis of post-Covid cardiorenal complications in patients with type 1 and type 2 diabetes mellitus according to the mobile diagnostic and treatment center (Diamobil)

https://doi.org/10.14341/probl13426

Abstract

BACKGROUND: Patients with diabetes mellitus (DM) are at risk for a higher incidence and severity of COVID-19, as well as its adverse outcomes, including post-Covid syndrome.

AIM: to assess the incidence of cardiorenal complications in patients with type 1 and type 2 diabetes (T1DM/T2DM) who have had COVID-19, and to analyze the structure and severity of disorders according to examination data at the Diamobil mobile medical diagnostic and treatment center.

MATERIALS AND METHODS: a cohort of T1DM and T2DM patients examined in Diamobil (n=318), with a confirmed anamnesis of COVID-19 (n=236). The time interval between COVID-19 and the visit to Diamobil was 8.7/8.2 months for T1DM/T2DM. The parameters of the last visit before COVID-19 recorded in the Federal Register of Diabetes (FRD) were used as initial data.

RESULTS: Clinical characteristics of patients with T1DM/T2DM: age — 49.2/64.5 years, duration of DM — 22/11 years, proportion of women — 64/73%, respectively. After analysis the data from visits before and after COVID-19 there weren’t statistically significant differences in HbA1c levels for both types of DM (before 9.0/8.3%; after 8.4/8.2%, respectively), there was the intensification of glucose lowering therapy (the proportion of patients with T2DM on 2 and 3 component therapy increased by 4.3% and 1.6%, the proportion of patients on insulin therapy by 16%). After COVID-19, there was a statistically significant decrease in glomerular filtration rate (GFR) in T1DM from 88.1 to 62 ml/min/1.73 m2; with T2DM from 74.7 to 54.1 ml/min/1.73 m2. When assessing acute diabetic complications, there was an increase in the frequency of coma in T1DM by 1.5 times, severe hypoglycemia in T1DM by 3 times, and in T2DM by 1.7 times. Analysis of the frequency of cardiorenal complications before and after COVID-19 showed a total increase of 8.5% in T1DM, by 13.2% in T2DM, of which myocardial infarction, ischemic heart disease, and CHF increased in T1DM in the range from 1.5 to 5 times, with T2DM by 1.3 times, the frequency of CKD with T1DM by 1.5 times, with T2DM by 5.6 times.

CONCLUSION: There was a decline of kidney filtration function (decrease in GFR) and an increase in the frequency of cardiovascular complications in both types of diabetes in post-Covid period while patients achieved a stable HbA1c levels by intensifying therapy during the COVID-19 infection. This fact reflects combined damage to the kidney and cardiovascular system as a part of the post-Covid syndrome and determines a key set of measures for the development of preventive strategies.

About the Authors

O. К. Vikulova
Endocrinology Research Centre
Russian Federation

Olga K. Vikulova - MD, PhD, associate professor

11 Dm. Ulyanova street, 117036 Moscow


Competing Interests:

None



A. V. Zheleznyakova
Endocrinology Research Centre
Russian Federation

Anna V. Zheleznyakova - MD, PhD, senior research associate

Moscow


Competing Interests:

None



A. A. Serkov
Endocrinology Research Centre
Russian Federation

Alexey A. Serkov

Moscow


Competing Interests:

None



M. A. Isakov
Endocrinology Research Centre
Russian Federation

Mikhail А. Isakov - PhD in Biology

Moscow


Competing Interests:

None



G. R. Vagapova
Kazan State Medical Academy
Russian Federation

Gulnar R. Vagapova

Kazan 


Competing Interests:

None



F. V. Valeeva
Kazan State Medical University
Russian Federation

Farida V. Valeeva

Kazan 


Competing Interests:

None



N. P. Trubicina
Endocrinology Research Centre
Russian Federation

Natalia P. Trubitsyna

Moscow


Competing Interests:

None



O. G. Melnikova
Endocrinology Research Centre
Russian Federation

Olga G. Melnikova

Moscow


Competing Interests:

None



V. K. Aleksandrova
Endocrinology Research Centre
Russian Federation

Vera K. Aleksandrova

Moscow


Competing Interests:

None



N. B. Smirnova
Endocrinology Research Centre
Russian Federation

Natalia B. Smirnova

Moscow


Competing Interests:

None



D. N. Egorova
Endocrinology Research Centre
Russian Federation

Dariya N. Egorova

Moscow


Competing Interests:

None



E. V. Artemova
Endocrinology Research Centre
Russian Federation

Ekaterina V. Artemova

Moscow


Competing Interests:

None



K. V. Sorokina
Endocrinology Research Centre
Russian Federation

Kliya V. Sorokina

Moscow


Competing Interests:

None



M. V. Shestakova
Endocrinology Research Centre
Russian Federation

Marina V. Shestakova - MD, PhD, Professor.

Moscow


Competing Interests:

None



N. G. Mokrysheva
Endocrinology Research Centre
Russian Federation

Natalya G. Mokrysheva - MD, PhD, Professor.

Moscow


Competing Interests:

None



I. I. Dedov
Endocrinology Research Centre
Russian Federation

Ivan I. Dedov - MD, PhD, Professor.

Moscow


Competing Interests:

None



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Supplementary files

1. Figure 1. Time intervals between patient visits before and after COVID-19.
Subject
Type Исследовательские инструменты
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2. Figure 2. The structure of hypoglycemic therapy in dynamics before and after COVID-19 in patients with type 2 diabetes.
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Type Исследовательские инструменты
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Indexing metadata ▾
3. Figure 3. The structure of diabetic complications before and after COVID-19 in patients with type 1 (A) and type 2 (B) diabetes.
Subject
Type Исследовательские инструменты
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Indexing metadata ▾
4. Figure 4. Distribution of patients by glomerular filtration rate and CKD stages before and after COVID-19 in patients with type 1 and 2 diabetes.
Subject
Type Исследовательские инструменты
View (233KB)    
Indexing metadata ▾

Review

For citations:


Vikulova O.К., Zheleznyakova A.V., Serkov A.A., Isakov M.A., Vagapova G.R., Valeeva F.V., Trubicina N.P., Melnikova O.G., Aleksandrova V.K., Smirnova N.B., Egorova D.N., Artemova E.V., Sorokina K.V., Shestakova M.V., Mokrysheva N.G., Dedov I.I. Multiplex analysis of post-Covid cardiorenal complications in patients with type 1 and type 2 diabetes mellitus according to the mobile diagnostic and treatment center (Diamobil). Problems of Endocrinology. 2024;70(4):65-74. (In Russ.) https://doi.org/10.14341/probl13426

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ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)