Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

8496

Unclassified

PATHOPHYSIOLOGY OF CARBOHYDRATE METABOLISM IN PATIENTS WITH DIABETES MELLITUS IN CORONAVIRUS INFECTION

Nefedova

Daria Sergeevna

studentnefedova_darya26@mail.ruhttps://orcid.org/0000-0002-8456-7607Frolov

Alexsandr Yurevich

studentfr0low.4@yandex.ruhttps://orcid.org/0000-0002-7617-7852Razenkov

Ivan Andreevich

studenti.razenkov@bk.ruhttps://orcid.org/0000-0003-1941-9285

Voronezh State Medical University named after N.N. Burdenko

20042023

12S2282284

21022023

24022023

2023

Relevance: According to the EF research group of the International Committee on Virus Systematics, on February 11, 2020, the official designation of the new virus, SARS-CoV-2, and the disease it causes, COVID-19, the most prominent manifestation of which is the development of severe bilateral pneumonia, was announced. SARS-CoV-2 belongs to the family of RNA-containing viruses whose entry gates are the epithelium of the upper respiratory tract, gastric and intestinal epitheliocytes. The virus penetrates and damages target cells with angiotensin-converting enzyme type II (ACE2) receptors. The severity of the course of the disease is largely caused by concomitant diseases, such as carbohydrate metabolism disorders. In this regard, the study of metabolic disorders in the body with worsening course of diabetes mellitus is of particular relevance. Objective: To study the pathophysiology of carbohydrate metabolism in COVID-19 coronavirus-infected patients with concomitant decompensated manifest type 2 diabetes mellitus. Methods of the study: The study analyzed the medical records of 47 patients aged 40 to 60 years (including 21 women and 26 men) diagnosed with coronavirus infection caused by COVID-19 virus with concomitant community-acquired bilateral multisegmental pneumonia with a moderate course (respiratory failure grade 1). The virus was confirmed by PCR test. The study was carried out on the basis of VOHKB №1. The results of the study were evaluated according to the indices of biochemical blood analysis in the acute phase of the disease (when the patient was admitted to the hospital) and in the recovery phase (when the patient was discharged). Such parameters as glucose, bilirubin, ALAT, ASAT, creatinine, urea, amylase, total protein and hematocrit were assessed. Statistical processing of the data was performed using Student's t-criterion at p0.05. Results:The studies revealed an increase in glucose levels on admission to the medical institution, with an average level of 10.58 mmol/l (9.8-12.1 mmol/l). It was revealed that in manifest DM hyperglycemia was persistent, despite increasing the dose of insulin to correct the condition, leveling of glucose levels to normal could not be achieved. At discharge, the mean glucose level was 7.43 mmol/L (6.7-7.8 mmol/L). Excess of the statistical average ASAT AND ALAT values was determined (in 87.6% and 81.3% of patients, respectively), indicating the activity of cellular cytolysis. Some average indices of biochemical blood analysis were within upper normal values, such as: bilirubin 15,622 mol/l (with the norm 8,5-20 mol/l), creatinine 87,84 mol/l (with the norm 60-124 mol/l), urea 8,260,7 mmol/l (with the norm 2,4-8,3 mmol/l). Amylase, total blood protein and hematocrit values corresponded to average normal values. Conclusion: On the basis of the data obtained in the study, it was found that hyperglycemia in patients with diabetes mellitus is exacerbated due to the specific action of the virus. This effect of the pathogen leads to a more severe course of the disease, namely severe pneumonia with severe respiratory failure, persistent inflammation and more severe complications such as hepatic and renal failure, as well as impaired function of these organs. Therefore, in this category of patients, it is important to conduct regular monitoring of blood glucose levels and measures to maintain sugar levels within normal limits. Thus, a detailed study of the conditions and mechanisms of COVID-19 exposure in patients with diabetes mellitus has significant scientific and practical importance for predicting the course of the disease, their complications and prescribing the appropriate specific therapy for this category of patients.

COVID-19diabetes mellituscarbohydrate metabolismhyperglycemia

COVID-19сахарный диабетуглеводный обменгипергликемия

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