Inflammatory markers in patients with decompensated type 2 diabetes mellitus and acute coronavirus infection

Abstract

Type 2 diabetes mellitus (T2DM) was found to be one of the main comorbidities in patients with COVID-19. However, there is a lack of studies regarding the relationship between glycated hemoglobin (HbA1c) levels, inflammatory markers, elevated body mass index (BMI) and disease severity in patients with T2DM and COVID-19. The aim of the study was to analyze inflammatory markers in patients with decompensated type 2 diabetes mellitus who were hospitalized with acute coronavirus infection. Materials and Methods. A retrospective study of 103 hospitalized patients was conducted from March 2020 to March 2024. Medical records of patients with acute SARS-CoV-2 infection and a confirmed history of T2DM were thoroughly reviewed. The study included 54 women (52.43%) and 49 men (47.57%). To study the inflammatory markers, two groups of patients were formed based on the main target indicator of glycemic control HbA1c. Group A (HbA1c < 7.0%) included 33 patients (32.04%), while Group B (HbA1c ≥ 7.0%) included 70 patients (67.96%). Results and discussion. Blood glucose levels were significantly higher in the group of patients with poorly controlled diabetes compared to the group with well-controlled diabetes – 10.8 [8.55–14.4] vs. 7.0 [5.9–9.3] (p < 0.001). In Group A, the median HbA1c level was significantly lower than in Group B, which is expected: 6.27 [6.08–6.63] vs. 8.55 [7.79–10.1] (p < 0.001). Patients with poorly controlled diabetes showed significantly higher C-reactive protein levels 95.1 [60.5–174] vs. 61.4 [14.7–138] (p = 0,021), more pronounced among women; neutrophilia 9.69 [6.48–14.5] vs. 6.1 [3.56–10.3] (p = 0,005); neutrophil-to-lymphocyte ratio 5.74 [3.17–9.97] vs. 4.22 [1.94–9.11] (p = 0,163). A direct correlation was observed between inflammatory markers interleukin-6 and ferritin in patients with poorly controlled diabetes and elevated HbA1c levels. Conclusions. In patients with poorly controlled diabetes, significantly higher levels of C-RP and pronounced neutrophilia were observed. A direct correlation was found between inflammatory markers IL‑6 and ferritin and elevated HbA1c levels in the group of patients with poorly controlled diabetes, confirming the link between chronic hyperglycemia and systemic inflammation.

Мета дослідження – проаналізувати маркери запального процесу в пацієнтів з декомпенсованим цукровим діабетом 2-го типу, госпіталізованих із гострою коронавірусною інфекцією. Проведено ретроспективне дослідження 103 пацієнтів, госпіталізованих у відділення лікарні з гострою інфекцією SARS-CoV-2 та цукровим діабетом 2-го типу. У групі пацієнтів із цукровим діабетом 2-го типу і поганим глікемічним контролем переважали пацієнти з високим індексом маси тіла (56,31%, p > 0,05), виявлено значно вищі рівні глікованого гемоглобіну, С-реактивного білку, нейтрофільозу. Встановлено статистично значущу пряму кореляцію між маркерами запалення інтерлейкіну-6 та феритину та високими рівнями глікованого гемоглобіну.