Peculiarities of Changes in Some Indicators of Hospitalization, Hemostasis and Procalcitonin in Patients with COVID-19 in the Presence of Diabetes Mellitus
Authors:   Poltava state medical university. 23, Shevchenko St., Poltava 36000, Ukraine, Ivanytska T. A. , Kazakov Yu. M. , Fam T. A. , Petrov Ye. Ye. 
Published: March 2022

The purpose of the study was to analyze changes in some indicators of hospitalization, hemostasis and procalcitonin, to determine the relationship between the level of D-dimer, platelets, international normalized ratio, procalcitonin and time of hospitalization and unfavorable prognosis in patients with acute respiratory disease COVID-19 with diabetes and without diabetes mellitus. Materials and methods. The study included 125 patients with acute respiratory viral disease COVID-19. The group with diabetes mellitus included 52 patients, the group without diabetes – 73. The information obtained from medical records contained demographic data, data on comorbidities, symptoms, treatment, nosocomial complications, laboratory results (including D-dimer, platelets, international normalized ratio, procalcitonin). All patients received treatment according to the protocol "Provision of medical care for the treatment of coronavirus disease (COVID-19)" #1979 dated 20.09.21. Results and discussion. The hospitalized patients with concomitant diabetes mellitus were significantly younger (p = 0.001), and the percentage of males was higher than in the comparison group. Among the patients in both groups, the percentage of comorbid cardiovascular disease (hypertension and coronary heart disease) had no significant differences. The rates of hospitalization in the intensive care unit and the mortality rate in the group of patients with diabetes were significantly higher (p = 0.03 and p = 0.02). The shorter period of hospitalization in the main group of patients (p = 0.006) can be explained by the higher mortality rate of this contingent. Indicators of D-dimer in patients with COVID-19 significantly exceeded the reference values. In our study, the indicators of D-dimer showed a tendency to increase in the group of concomitant diabetes mellitus. The rates of hospitalization in the intensive care unit and the mortality rate in the group of patients with diabetes were significantly higher (p = 0.03 and p = 0.02), although the duration of hospitalization was lower in the group of patients with diabetes (p = 0.006). Platelet levels in the same group were significantly lower (p = 0.03), and thrombocytopenia with high D-dimer was associated with mortality. We found a strong direct correlation between D-dimer, procalcitonin and mortality (r = 0.72, and r = 0.75, respectively), and the mean level of D-dimer in the main group of patients who did not survive the disease was significantly higher than of those who recovered. Conclusion. Patients with acute respiratory viral disease COVID-19 on the background of diabetes have a more severe course of the disease and a worse prognosis compared with those who do not have impaired glycemia. Determination of platelet, D-dimer and procalcitonin levels are reliable parameters for assessing the course of the disease and predicting mortality in patients with COVID-19, especially in conditions of comorbidity with diabetes