Diabetes - a Consequence of COVID-19 Infection.

Background: COVID-19 infection has shown many complications on all organ systems, including the pancreas, during the acute phase of infection and in the post covid period. Objective: Our goal was to compare the frequency of patients with type 1 and type 2 diabetes in the Outpatient Clinic "Srce Sarajeva", in the year before COVID-19, 2019, and during the COVID-19 infection, in 2020 and 2021. Our second goal was to monitor the incidence of diabetes after COVID-19 infection, the time of onset after the acute phase of the disease, and treatment options for individual patients depending on the value of glucose. Methods: The study was designed as a retrospective-prospective, with the consent of the Director of the Outpatient Clinic "Srce Sarajeva", and patient consent, in the period of January 2019 to December 2021. The study included 371 patients at the age between 18-70. Results: In 2020 and 2021 there was a significant difference in the number of patient diagnosed with diabetes who came for examination, compared to 2019. The number of new-onset diagnosed patients with type 1 and type 2 diabetes was significantly higher in 2020 and 2021 compared to 2019. In 2020, out of five newly discovered type 1, 3 of them, with an average age of 23 (+/- 1-4), overcame COVID-19 infection, and diabetes was detected 3-4 weeks after overcoming COVID-19 infection. Of the 122 type 2 patients, 19 were newly diagnosed, 47 were of average age (+/- 2-6), 13 were COVID-19 infected, and diabetes was detected 4-6 weeks after infection. In 2021, out of 4 newly discovered type 1, 3 of them, with an average age of 22 (+/- 1-2), overcame COVID-19 infection, and diabetes was detected 2-3 weeks after overcoming COVID-19 infection. Of the 114 type 2 patients, 32 were newly diagnosed, 45 were of average age (+/- 2-6), 23 were COVID-19 infected, and diabetes was detected 6-8 weeks after infection. Conclusion: COVID-19 infection adversely affects the pancreatic tissue leading to the clinical picture of type 1 and type 2 diabetes, and all patients, especially those at high risk of developing the disease suggest blood sugar testing, 3-4 weeks after the acute phase of the disease, and earlier if they were on corticosteroid therapy.

Hypothyroidism and Subclinical Hypothyroidism as a Consequence of COVID-19 Infection.

Background: Hypothyroidism occurs as a consequence of chronic autoimmune inflammation of the thyroid gland, which occurs due to the reduced function in the secretion of hormones FT3 and FT4 and requires replacement therapy for life. CoV-19 infection has shown many complications in all organic systems, during the acute phase of infection and in the post COVID period. Objectives: The aim of the study was a) to compare the frequency of patient visits for hypothyroidism and the average dose of levothyroxine in the SANASA polyclinic in the year before COVID pandemic, in the early 2019, with the frequency of patient visits during COVID infection in 2020 and 2021; b) to determine the incidence of hypothyroidism after the COVID 19 infection, the time of onset of hypothyroidism after acute phase of the disease, and the average dose of levothyroxine; and c) to monitor the incidence of subclinical hypothyroidism, which did not require substitution, before and after COVID 19 infection. Methods: In the SANASA polyclinic from the 2019 database we found 58 patients, at the age between 18-70 years, 53 women and 2 men with hypothyroidism and 2 female and 1 male patients with subclinical hypothyroidism. In 2020 there were a total of 89 patients, 73 women and 4 men with hypothyroidism, and 9 women and 3 men with subclinical hypothyroidism. In the 2021 there were 101 patients, 86 women and 7 men with hypothyroidism and 7 female and 1 male patients with subclinical hypothyroidism. Results: There was a significant difference in the number of patients with hypothyroidism and subclinical hypothyroidism during 2020 and 2021 in relation to 2019. The average dose of levothyroxine per patient did not differ statistically, comparing all three years, as well as comparing those who were ill, compared to patients who did not have COVID-19. There were diagnoses of post COVID subclinical hypothyroidism in 2020, as in 2021, with an average time of diagnosis of 2 months after infection for clinical hypothyroidism and 8 weeks for subclinical hypothyroidism. Conclusion: CoV-19 infection adversely affects thyroid tissue causing clinical hypothyroidism, requiring levothyroxine substitution as well as subclinical hypothyroidism which should be monitored.

Correlation Between Inflammatory and Biochemical Parameters in Patients with Diabetes and Urinary Tract Infection.

BACKGROUND: Hyperglycemia, polyuria, and glycosuria are all risk factors for the frequency of urinary tract infections in patients with diabetes. OBJECTIVE: The aim of this study is to establish correlation between inflammatory and biochemical parameters in patients with diabetes and urinary tract infection. METHODS: Total number 116 patients were monitored, at the ages between 18-95 years, with diabetes and urinary tract infection, of which 59.49% women and 40.51% men. Patients were with a duration of diabetes from 0 to over 20 years, with an average fasting glycemia of 9.54 mmol/l, and postprandial glycemia 13.94 mmol/l, HbA1C 9.92%, which have been poorly regulated in the last 3-4 months. Inflammatory parameters SE, CRP, leukocytes were correlated with inflammatory parameters of urine sediment and positive urine cultures. RESULTS: Average values of urea, creatinine, and proteinuria were positively correlated with the duration of diabetes. Escherichia coli, Enterococcus feecalis, and Candida albicans were the most common pathogens isolated in urine culture, 51 patients had reinfection once, 39 patients had two reinfections, and 26 patients had three reinfections during the 6-month follow-up. CONCLUSION: Duration of diabetes, long-term poor glycoregulation lead to microangiopathic changes in the kidneys in the form of diabetic nephropathy with retention of nitrogenous substances of urea, creatinine with proteinuria, and acute hyperglycemia, polyuria and glycosuria, further leading to frequent urinary tract infections.