Weight loss in patients with COVID-19 and Influenza in comorbidity with NCDs: a pilot prospective clinical trial
Authors: Oshakbayev Kuat , Durmanova Aigul , Idrisov Alisher , Zhankalova Zulfiya , Bedelbayeva Gulnara , Gazaliyeva Meruyert , Tordai Attila , Nabiyev Altay , Dukenbayeva Bibazhar 
Published: December 2022

Background

COVID and Influenza with non-communicable chronic diseases (NCDs) complicate the diagnosis, treatment, prognosis, and increase mortality rate. The aim: to evaluate the effects of the fast weight loss on clinic and laboratory inflammation profile, metabolic profile, reactive oxygen species (ROS) and body composition in patients with COVID and Influenza in comorbidity with NCDs.

Methods

A 6-week open, pilot prospective clinical trial including 62 adult patients with COVID (n=27) and influenza (n=35) in comorbidity with T2D, hypertension, and NASH. Overweight in 33 patients (53.2%) with BMI 28.14±0.39 kg/m2, and 29 patients without overweight with BMI 23.37 ± 0.38 kg/m2. T2D in 26 (41.9%); Hypertension in 38 (61.3%) (incl. 12 patients with T2D); NASH in 51 patients (82.2%) (incl. 8 patients with NASH, T2D and Hypertension; 6 patients with NASH and T2D; 18 patients with NASH and Hypertension; 19 patients with only NASH). Primary endpoints: Clinic/infectious/inflammation tests for COVID and Influenza; weight loss during 14 days. Secondary endpoints: fasting blood glucose, HbA1c, blood insulin; systolic/diastolic BP; blood lipids; ALT, AST, chest CT-scan.

Results

The patients with overweight lost -12,4% from baseline or BMI= -4.2 kg/m2, and patients without overweight lost -9,14% from baseline or BMI= -2.2 kg/m2(−9.7±0.7 kg vs. - 6.4±0.6 kg, respectively;P<0.001) at 14-day of the treatment. Weight loss in both groups was due to reduction of fat mass (P<0.0001).

Sputum production increased in 1.0-1.5 liter/day on 2-3 days, decreased in 7-9 days. Body temperature normalized in 6-9 days. On 3-5 days, in most patients their urine became turbid/muddy/intensively colored. Urine microscopy showed organic and non-organic salts, and leukocyturia (20-35/sight).

White blood cells, lymphocytes, NLR normalized at 14 days (P<0.0001). Total-fibrinogen, C-reactive-protein, and Erythrocyte-sedimentation-rate, ROS normalized at 14-day of treatment (P<0.0001).

COVID and Influenza were a negative in >96.3% patients at 14-day. Systolic/diastolic BP decreased (161.3±1.31/101.6±0.85 vs. 118.3±0.46/80.89±0.66,P<0.0001), glucose and lipids metabolism in patients with T2D (n=26) (P<0.0001); ALT and AST in patients with NASH (n=51) were significantly normalized (from baseline 134.3±5.4 and 166.5±5.5 U/L, respectively, and at 14-day to 78.4±4.2 and 92.4±4.9 U/L, respectively (P<0.0001)), platelets increased from baseline (186.5±4.6, ×109/L) at 14-day of treatment (238.5±5.8, ×109/L) (P<0.0001), and at 6-week follow-up (278.3±6.9, ×109/L) (P<0.0001). The mean score of chest-CT for the patients (n=44) was 13.12±0.38 from baseline, and at 14-day the score was 1.72±0.12 (P<0.0001). ROS level normalized at 14-day treatment and 6-week follow-up from baseline (P<0.0001). The previous antidiabetic, antihypertensive, anti-inflammatory and hepatoprotective, and other symptomatic medications were adequately decreased in 2-5 days to completely stopping by 5-8 days treatment.

Conclusions

The fast weight loss is clinical/laboratory benefit in treatment of patients with COVID-19 and Influenza in comorbidity with T2D, hypertension, and NASH.

Trial Registration

ClinicalTrials.govNCT05635539. Registered 1 December 2022.