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One of the rare and life-threatening conditions is acute aortic thrombosis. We have described a case of thrombosis of the aorta and iliac arteries in a patient against the background of viral pneumonia COVID-19, with newly diagnosed diabetes mellitus and arterial hypertension.Copyright © 2021 The authors. All right reserved.
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BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID-19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID-19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULTS: Case fatality rate in patients with DM, who underwent COVID-19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >= 65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03-7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >= 10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability ( OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID-19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium- glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION: The common risk factor for fatal outcome in both DM1 and DM2 was age >= 65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >= 10 years, BMI >= 30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively.
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BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively.Copyright © Endocrinology Research Centre, 2022.
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BACKGROUND: The COVID-19 pandemic has accelerated the development of telemedicine technologies. Today there is evidence of the successful use of telemedicine in various fields of health care, in particular in endocrinology. At the same time, there is not enough information for effective integration of telemedicine into the management of patients with various endocrinopathies. AIM: The aim of this study is a clinical and demographic assessment of the structure of telemedicine consultations (TMC) conducted at the Endocrinology Research Centre in 2020-2021. MATERIALS AND METHODS: A single-stage, single-center retrospective study was conducted. The study included all patients who received at least one TMC at the Endocrinology Research Centre in 2020-2021. Clinical and demographic information was analyzed (gender, age of patients, region of residence, ICD-10 code). All patients signed voluntary informed consent for TMC. The obtained data were processed using the Microsoft Office 2013 software package. RESULTS: In 2020, 1,548 TMC were held, in 2021 - 4180 TMC. Among adults, women predominated in the structure of referrals (83-86%), among children there is a tendency towards equivalent referrals for boys and girls (in 2021 - 45% and 55%, respectively). The median age of adult patients in 2021 was 38 years [31; 53], among children - 11 years [7; 14]. In 2020, residents of 74 regions of the Russian Federation applied for TMC, in 2021 - of 82 regions. There is a tendency towards the prevalence of patients from the Central, Volga, Southern and North Caucasian federal districts in the TMC structure. Diseases of the thyroid gland predominated in the nosological structure of TMC. CONCLUSION: TMC turned out to be in demand in patients with a wide variety of endocrinopathies. It is important to conduct further analysis of both the TMC market and the effectiveness of remote counseling for various nosologies to determine the place of telemedicine in the modern healthcare structure and to introduce TMK into the system of clinical guidelines and programs of territorial compulsory medical insurance funds.
Subject(s)
COVID-19 , Telemedicine , Adult , COVID-19/epidemiology , Child , Demography , Female , Humans , Male , Pandemics , Referral and Consultation , Retrospective StudiesABSTRACT
BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively. Copyright © Endocrinology Research Centre, 2022.
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BACKGROUND: The coronavirus pandemic has had an extremely negative impact on the patients with diabetes mellitus (DM both in terms of a more severe course of COVID -19 and an increased risk of death. AIM: Analysis of risk factors for death due to COVID -19 in patients with DM type 1 and type 2 (DM1 and DM2). MATERIALS AND METHODS: Retrospective analysis of the database of the national diabetes register (NDR), which included DM patients with COVID-19 and reported virus infection outcome (recovery/or death) in 15 712 DM1 and 322 279 DM2 patients during a 2-year follow-up period (01/02/2020 to 03/04/2022) (discharge date)). RESULT(S): Case fatality rate in patients with DM, who underwent COVID -19 was 17.1% (DM1-8.8%;DM2-17.5%). As a result of multivariate regression analysis of seven significant factors in DM1 and thirteen in DM2 (evaluated by univariate anlisys), a number of the most important predictors of risk for fatal outcome were identified: in DM1 these were age >=65 years (OR =4.01, 95% CI: 1.42-11.36), presence of arterial hypertension (AH) (OR =2.72, 95% CI: 1.03 -7.16) and diabetic foot syndrome (DFS) (OR = 7.22, 95% CI: 1.98-26.29);for T2DM: age >= 65 years (OR =2.53, 95% CI: 1.96-3.27), male (OR =1.51, 95% CI: 1.23-1.84), duration DM >=10 years (OR =2.01, 95% CI: 1.61-2.51), BMI >= 30 kg/m2 (OR =1.26, 95% CI: 1.02-1.55), ASCVD/CKD (OR =1.49, 95% CI: 1.01-2.04), history of diabetic coma (OR =12.97, 95% CI: 1.89-88.99) and presence of disability (OR =1.40, 95% CI: 1.14-1.73). In T2DM, the type of antidiabetic therapy (ADT) prior to COVID -19 (last visit before the development of infection) had a significant impact: Insulin therapy (OR = 1.64, 95% CI: 1.30-2.07), sulfonylureas (SU) (OR =1.51, 95% CI: 1.23-1.84));dipeptidyl peptidase-4 inhibitor (iDPP-4) therapy (OR =0.57, 95% CI: 0.39-0.83) and sodium-glucose cotransporter-2 inhibitor (iSGLT2) therapy (OR =0.64, 95% CI: 0.46-0.88). Vaccination was the most important protective factor in both types of DM: DM1 OR =0.19, 95% CI: 0.06-0.59;SD2 OR =0.20, 95% CI: 0.16-0.26. CONCLUSION(S): The common risk factor for fatal outcome in both DM1 and DM2 was age >=65 years;in DM1 - history of hypertension and DFS, in DM2 - male sex, diabetes duration >=10 years, BMI >=30 kg/m2, history of ASCVD/CKD and diabetic coma, disability. In T2DM, significant differences in risk were observed depending on the type of ADT: insulin and SU therapy were factors that increased the risk of death, whereas therapy with iDPP-4 and iSGLT2 reduced the risk of death. Vaccination reduced the risk of death in DM1 and DM2 by 5.2 and 5-fold, respectively. Copyright © Endocrinology Research Centre, 2022.
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BACKGROUND: COVID-19 is a disease that has a negative systemic effect on the human body, including the male gonads. Therefore, the androgenic status in men with COVID-19 needs to be studied. AIM: To evaluate the levels of total testosterone, sex hormone binding globulin (SHBG) and free testosterone in men in the acute phase of COVID-19 and during convalescence. MATERIALS AND METHODS: A continuous dynamic prospective study of 70 men with moderate to severe COVID-19 at the age of 50[44; 64] years. During the study, the levels of total testosterone, SHBG were determined with further calculation of the level of free testosterone by Vermeullen. The data were collected twice - at the patient's hospitalization and at his discharge. The differences between the groups were considered statistically significant at p <0.05. RESULTS: At the time of hospitalization for COVID-19, hypogonadism syndrome was observed in 61 people - 87%. Patients with hypogonadism did not statistically significant differ in age and severity of COVID-19 disease compared to men without hypogonadism. Inpatient treatment lasting 12[10;14] days resulted in a statistically significant increase in the levels of total testosterone from 4,7[2,96;8,48] to 12,85[8,62;19,2] nmol/l, p<0,001; SHBG from 27,87[20,78;36,57] to 33,76[26,27;52,60] nmol/l, p<0,001 and free testosterone from 107[65;174] to 235[162;337] pmol/l, p<0,001. This led to the elimination of hypogonadism in 28 patients - 40%. Patients with persistent hypogonadism were statistically significantly older than men with normalized testosterone, there were no statistically significant differences in the initial levels of total testosterone, SHBG and free testosterone, and there were also no differences in the prevalence of severe COVID-19 (3,97[2,86;7,46] vs 4,26[2,93;5,96] nmol/l, p=0,100; 28,76[20,78;48,59] vs 24,63[18,85;31,70] nmol/l, Ñ=0,994; 100[58;118] vs 96[64;143] pmol/l, p=0,522; 24 пÑоÑив 18%, p=0,754, respectively). CONCLUSION: COVID-19 has a pronounced negative effect on the production of testosterone in men, leading to the development of laboratoric hypogonadism, which is potentially reversible. The reversibility of laboratoric hypogonadism is typical for younger patients.
Subject(s)
COVID-19 , Hypogonadism , Androgens , COVID-19/epidemiology , Humans , Hypogonadism/complications , Hypogonadism/epidemiology , Male , Middle Aged , Prospective Studies , TestosteroneABSTRACT
A dangerous viral disease COVID-19, caused by a new RNA coronavirus SARS-COV-2, has been actively spreading in the world since December 2019. The main manifestations of this disease are bilateral pneumonia, often accompanied by the development of acute respiratory syndrome and respiratory failure. Patients with diabetes mellitus (DM) are at high risk of infection with the SARS-COV-2 virus, severe illness and death. Maintaining of target glycemic levels is the most important factor in a favorable outcome of COVID-19 in both type 1 and type 2 DM. The choice of antihyperglycemic therapy in a patient with DM in the acute period of COVID-19 depends on the initial therapy, the severity of hyperglycemia, the severity of the viral infection and the patient's clinical condition. The article presents the recommendations of the board of experts of the Russian Association of Endocrinologists on glycemic control and the choice of antihyperglycemic therapy in patients with type 2 DM and COVID-19, and also on the use of glucocorticosteroids used in the treatment of COVID-19 in patients with type 2 DM. Copyright © Endocrinology Research Centre, 2022.
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The aim To study the association of demographic, clinical, and laboratory factors and the use of glucose-lowering drugs and anti-coronavirus disease (COVID-19) vaccination with the COVID-19-related case fatality rate (CFR) in diabetes mellitus (DM) patients. Methods This study is a nationwide observational cohort study based on the data from the National Diabetes Register (NDR) that is the database containing online clinical information about the population with DM. The outcomes (death or recovery) for COVID-19 were registered in 235,248 patients with DM [type 1 diabetes mellitus (T1DM), n = 11,058;type 2 diabetes mellitus (T2DM), n = 224,190] from March 20, 2020, until November 25, 2021. The unadjusted odds ratio (OR) and 95% confidence interval (CI) were used to estimate the risk factors for CFR. Then the ranging of significant factors was performed and the most vulnerable groups of factors for the lethal outcome were chosen. Results The CFR due to COVID-19 was 8.1% in T1DM and 15.3% in T2DM. Increased CFR was associated with the male population [OR = 1.25 (95% CI: 1.09–1.44) in T1DM and 1.18 (95% CI: 1.15–1.21) in T2DM], age ≥65 years [OR = 4.44 (95% CI: 3.75–5.24) in T1DM and 3.18 (95% CI: 3.09–3.26) in T2DM], DM duration ≥10 years [OR = 2.46 (95% CI: 2.06–2.95) in T1DM and 2.11 (95% CI: 2.06–2.16) in T2DM], body mass index (BMI) ≥30 kg/m2 [OR = 1.95 (95% CI: 1.52–2.50)] in T1DM, HbA1c ≥7% [OR = 1.35 (95% CI: 1.29–1.43)] in T2DM. The atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD) were associated with higher CFR in T1DM but not in T2DM. The pre-COVID-19 glucose-lowering therapy in T2DM was differently associated with CFR (OR): 0.61 (95% CI: 0.59–0.62) for metformin, 0.59 (95% CI: 0.57–0.61) for dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), 0.46 (95% CI: 0.44–0.49) for sodium-glucose co-transporter-2 (SGLT2) inhibitors, 0.38 (95% CI: 0.29–0.51) for glucagon-like peptide-1 receptor agonists (arGLP-1), 1.34 (95% CI: 1.31–1.37) for sulfonylurea (SU), and 1.47 (95% CI: 1.43–1.51) for insulin. Anti-COVID-19 vaccination was associated with a lower fatality risk in both DM types: OR = 0.07 (95% CI: 0.03–0.20) in T1DM and OR = 0.19 (95% CI: 0.17–0.22) in T2DM. Conclusions The results of our study suggest that increased COVID-19-related fatality risk in both T1DM and T2DM patients associated with the male population, older age, longer DM duration, and absence of anti-COVID-19 vaccination. In T2DM, pre-COVID-19 glucose-lowering therapy with metformin, DPP-4 inhibitors, SGLT2 inhibitors, and arGLP-1 had a positive effect on the risk of death. The most vulnerable combination of risk factors for lethal outcome in both DM types was vaccine absence + age ≥65 years + DM duration ≥10 years.
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Diabetes mellitus stays an important medical, economic and social problem worldwide. Infectious diseases in people with diabetes mellitus are often more severe with an increased frequency of hospitalizations and complications. The presence of chronic hyperglycemia leads to decreased immune function and an increased predisposition to infections. Infections lead to uncontrolled hyperglycemia, which worsens the course of infections, thus forming a vicious circle of violations. Mass vaccination with an emphasis on people belonging to the high-risk group reduces the number of infected and, hospitalized people, and also has clear economic advantages. However, in many countries the proportion of vaccinated remains low. Vaccine prophylaxis in Russia is regulated by a number of regulatory legal acts, of which the main one is Federal Law No. 157-FZ of September 17, 1998 (edited on July 2, 2021) "About Immunoprophylaxis of Infectious Diseases". Each country has a National Vaccination Schedule, which shows a routine vaccination schedule at a specific age against infections that are widespread and / or pose a serious threat to health and life), as well as a National Epidemic Indication Vaccination Schedule. In Russia, these documents are approved by Order of the Ministry of Health of the Russian Federation of March 21, 2014 N 125. "About the approval of the national calendar of preventive vaccinations and the calendar of preventive vaccinations for epidemic indications." This article discusses vaccination against the most socially significant infections associated with a high worldwide prevalence and increased risk among people with diabetes.
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A dangerous viral disease COVID-19, caused by a new RNA coronavirus SARS-COV-2, has been actively spreading in the world since December 2019. The main manifestations of this disease are bilateral pneumonia, often accompanied by the development of acute respiratory syndrome and respiratory failure. Patients with diabetes mellitus (DM) are at high risk of infection with the SARS-COV-2 virus, severe illness and death. Maintaining of target glycemic levels is the most important factor in a favorable outcome of COVID-19 in both type 1 and type 2 DM. The choice of antihyperglycemic therapy in a patient with DM in the acute period of COVID-19 depends on the initial therapy, the severity of hyperglycemia, the severity of the viral infection and the patient's clinical condition. The article presents the recommendations of the board of experts of the Russian Association of Endocrinologists on glycemic control and the choice of antihyperglycemic therapy in patients with type 2 DM and COVID-19, and also on the use of glucocorticosteroids used in the treatment of COVID-19 in patients with type 2 DM.
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One of the rare and life-threatening conditions is acute aortic thrombosis. We have described a case of thrombosis of the aorta and iliac arteries in a patient against the background of viral pneumonia COVID-19, with newly diagnosed diabetes mellitus and arterial hypertension. © 2021 The authors. All right reserved.
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Adipose tissue mostly composed of different types of fat is one of the largest endocrine organs in the body playing multiple intricate roles including but not limited to energy storage, metabolic homeostasis, generation of heat, participation in immune functions and secretion of a number of biologically active factors known as adipokines. The most abundant of them is adiponectin. This adipocite-derived hormone exerts pleiotropic actions and exhibits insulin-sensitizing, antidiabetic, anti-obesogenic, anti-inflammatory, antiatherogenic, cardio- and neuroprotective properties. Contrariwise to its protective effects against various pathological events in different cell types, adiponectin may have links to several systemic diseases and malignances. Reduction in adiponectin levels has an implication in COVID-19-associated respiratory failure, which is attributed mainly to a phenomenon called 'adiponectin paradox'. Ample evidence about multiple functions of adiponectin in the body was obtained from animal, mostly rodent studies. Our succinct review is entirely about multifaceted roles of adiponectin and mechanisms of its action in different physiological and pathological states.
Subject(s)
Adiponectin , Adipokines , Adiponectin/physiology , Adipose Tissue , Animals , COVID-19 , HumansABSTRACT
Due to global spread of COVID-19, the search for new factors that could influence its clinical course becomes highly important. This review summarize the relevant publications on the association between immune system and the main regulators of mineral homeostasis including. In addition, we have highlighted the various aspects of phosphorus-calcium metabolism related to the acute respiratory diseases and in particular to COVID-19. The data about the calcium-phosphorus metabolism in SARS-CoV-2 infection is required to understand the possible clinical implications and to develop new therapeutic and preventive interventions.
Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , Vitamin D Deficiency/drug therapy , Vitamin D/therapeutic use , Parathyroid Hormone , Calcium/metabolism , SARS-CoV-2 , Phosphorus/metabolism , MineralsABSTRACT
Background. COVID-19 disease is often severe, and therefore it is rational to use vaccination. But many men have concerns about its effect on fertility, which requires clarification. Aim. Evaluation of the quality of the ejaculate and the levels of total testosterone during the use of the Gam-Covid-Vac vaccine (Sput-nik-V). Material and methods. The pilot observational prospective study included 30 men with normozoospermia and 30 with pathozoosper-mia, who have been vaccinated with Gam-Covid-Vac. The study period was from March 2021 to June 2021. The total blood testosterone level and parameters of ejaculate quality were determined. The comparisons were carried out in dynamics, the differences were considered statistically significant at p<0.05. Results. The effect of vaccination on total testosterone levels was not revealed. The effect of vaccination on the parameters of the ejaculate quality in patients with pathozoospermia was not revealed. In the group of patients with normozoospermia among patients with impaired sperm motility, which was –5[–7;–3]% and had no clinical significance, an increase in temperature after vaccination was statistically significantly more frequent. Conclusion. There was no negative effect of the vaccine on total testosterone levels and ejaculate quality. © 2021, Media Sphera Publishing Group. All rights reserved.
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BACKGROUND: Less than a year has passed since the start of the new coronavirus infection COVID-19 pandemic caused by SARS-CoV-2. First published research results demonstrate a frequent increase in glycemia in patients without previously diagnosed carbohydrate metabolism disorders. A possible relationship between the carbohydrate metabolism state and the course of COVID-19 is considered. AIM: To identify the incidence of known and newly diagnosed diabetes mellitus (DM) in hospitalized patients with COVID-19 and evaluate the relationship between glycated hemoglobin (HbA1c), inflammation markers and infectious disease severity. METHODS: A single-center, cross-sectional, retrospective study included 155 patients with confirmed COVID-19 and bilateral polysegmental viral pneumonia hospitalized in the Endocrinology Research Centre, Russian Federation. Diagnosis of carbohydrate metabolism disorders was based on the HbA1c level, blood glucose level at admission (BGA) and fasting plasma glucose (FPG). Patients were divided into 2 groups: without the previously diagnosed DM (n=129, 83.3%) and with known history of DM (n=26, 16,7%). Patients without previously diagnosed DM were divided into subgroups according to HbA1c levels: ≤6,0% (Group A), >6,0% HbA1c, <6.5% (Group B), ≥6,5% (Group C). Additionally, insulin, interleukin 6 (IL-6) and D-dimer levels were measured in all patients. Blood oxygen saturation (SpO2) was measured by pulsoximetry, computerized tomography of lungs with calculation of lung parenchyma damage percentage. RESULTS: Type 2 DM was previously established in 16.7% of all included patients. Among patients without DM history, DM was revealed in 8 patients (5.2%), based on HbA1c, FPG and BGA. In 66 patients (42.6%) we observed no changes in carbohydrate metabolism. In 55 patients, the interpretation of carbohydrate metabolism state was difficult due to inconsistency of HbA1c level with FPG and BGA: In particular, the level of HbA1c ≥ 6.5% (which corresponds to the diagnostic threshold of the DM) was detected in 19 patients (12,2%) with normal FPG and BGA. No true stress hyperglycemia on admission and according to FPG was reported. Despite the presence of confirmed DM, HbA1c levels positively correlated with inflammatory markers (erythrocyte sedimentation rate, C-reactive protein, IL-6) and SpO2. Patients with a HbA1c ≥6.5% without DM history had the most severe course of the disease: Longest duration of hospitalization, largest damage of the pulmonary tissue, and high lethality. CONCLUSION: The incidence of DM among patients hospitalized with COVID-19 was 21.9% (16.7% had previous diagnosis of DM, 5.2% - newly diagnosed), which is 1.5 times higher than in general population in a comparable age category. It is difficult to assess the carbohydrate metabolism disorders in patients in acute infectious period. An increased level of HbA1c (≥6.5%), first detected in the acute period of infection, in combination with normal FPG and BGA parameters, cannot be a diagnostic criterion and requires dynamic monitoring. HbA1c level can be considered as a predictive factor of COVID-19 severity, independent of DM.
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Increasingly, there is evidence of the association of mineral metabolism with COVID-19, in particular states such as hypocalcaemia, vitamin D deficiency, which may weigh up the course of a new coronavirus infection. Objective. Evaluate the basic parameters of mineral metabolism in patients with COVID-19 of different severity at admission to the hospital. Material and methods. A single-center study was carried out at the Endocrinology Research Centre, Moscow. Analysis of the mineral metabolism parameters, as well as clinical and instrumental assessment of the COVID-19 severity before specific immunotherapy was performed in 60 patients. Results. The frequency of hypocalcemia (according to the level of albumin-adjusted calcium) and vitamin D deficiency/insufficiency in the study group was 36.7 and 95%, respectively. Lower saturation (SpO2) was observed in the subgroup with a lower level of 25(OH)D (p=0.001) and calcium (p=0.002). Patients with severe COVID-19 pneumonia (computer tomography (CT) scan grade 3-4) compared with those with less changes (CT grade 1-2) had significantly lower total calcium and albumin (p<0.001 for both). Decreased vitamin D levels were associated with higher CRP values (OR 0.892, 95% CI 0.8-0.995) and lower SpO2 (OR 1.227, 95% CI 1.028-1.465). Conclusion. The severe course of COVID-19 is associated with significantly lower levels of 25(OH)D and calcium, which indicates the necessity for their timely correction. Further research is needed to determine the impact of impaired mineral metabolism on COVID-19 to develop the optimal therapeutic approach to patients with SARS-CoV-2. © 2020, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
A link between vitamin D deficiency and susceptibility to infectious diseases was suggested over a hundred years ago. Epidemiological studies show a strong association between seasonal fluctuations in vitamin D levels and the incidence of various infectious diseases, including septic shock, acute respiratory infections, and influenza. Our understanding of vitamin D metabolism and its extra-skeletal functions has improved significantly over the past three decades, and the discovery that the vitamin D receptor and 1a-hydroxylase, an enzyme needed to convert vitamin D to its active form, is present in the cells of the immune system, revolutionized in this area. Recent studies have shown that vitamin D regulates the expression of specific endogenous antimicrobial peptides in immune cells, modulates the immune response and the course of autoimmune processes; these actions indicate the potential role of vitamin D in modulating the immune response to various infectious diseases. This publication reviews the literature on the effects of vitamin D on immunity, its potential in the prevention and treatment of viral diseases, with a particular focus on COVID-19.
Subject(s)
COVID-19 , Virus Diseases , Dietary Supplements , Humans , SARS-CoV-2 , Seasons , Virus Diseases/epidemiology , Vitamin DABSTRACT
Progressive decrease in the weight and functional reserve of β-cells is one of the main pathogenetic mechanisms of development of type 2 diabetes mellitus (DM2). The rate of progression of these processes is strictly individual, which largely determines the course of DM2 and the effectiveness of the therapy. As a rule, apoptosis and necrosis are the main mechanisms of β-cell damage and death in CD2. At the same time, recent studies allow us to consider the destruction and death of β-cells as the outcome of other types of programmed cell death (PCG), the role of innate immunity in the Genesis of CD2 IS actively discussed. This article provides an overview of the data of domestic and foreign literature of recent years regarding the molecular, intracellular characteristics of different types of β-cell PCG in CD2. The results of studies aimed at studying the possible factors and processes leading to their launch are presented.