А. П. Шепелькевич, Ю. В. Дыдышко
УО «Белорусский государственный медицинский университет»
В статье представлен аналитический обзор данных клинических исследований об особенностях манифестации и течения COVID-19 у пациентов с ожирением и сахарным диабетом. Проанализированы возможные механизмы взаимосвязи более тяжелого течения вирусной инфекции у пациентов с ожирением и сахарным диабетом. Приведены данные, свидетельствующие о роли сахарного диабета в качестве значимого предиктора неблагоприятных исходов инфекции COVID-19. Кроме того, суммированы результаты исследований, свидетельствующих о возможности прямого воздействии SARS-CoV-2 на функцию β-клеток, что ассоциировано с быстрым и значимым ухудшением метаболического контроля у пациентов с ранее диагностированным сахарным диабетом или повышением риска развития впервые выявленного диабета. Указаны известные в настоящее время особенности применения сахароснижающих лекарственных средств при COVID-19. Также авторами сделан вывод о том, что для детального понимания механизмов, обусловливающих тяжелое течение COVID-19 при ожирении и сахарном диабете, необходимы дальнейшие исследования по оценке показателей респираторной дисфункции, кардиометаболических, иммунных, воспалительных и тромботических факторов, а также особенностей фармакотерапии.
ключевые слова: COVID-19, ожирение, сахарный диабет
Obesity and diabetes mellitus predictors of poor COVID-19 outcomes
A. P. Shepelkevich, Yu. V. Dydyshko
The article provides an analytical review of clinical research data on the features of the manifestation and duration of COVID-19 in patients with obesity and diabetes mellitus. Possible mechanisms of interrelation of more severe course of viral infection in patients with obesity and diabetes mellitus were analyzed. The paper provides evidence of the role of diabetes mellitus as a significant predictor of severe outcomes of COVID-19. The results of studies showing the possibility of a direct effect of SARS-CoV-2 on β-cell function, which is associated with a rapid and significant deterioration of metabolic control in patients with previously diagnosed diabetes mellitus or an increased risk of developing newly diagnosed diabetes, are summarized. The currently known features of the use of antidiabetic drugs for COVID-19 are indicated. The authors also concluded that for a detailed understanding of the mechanisms underlying the severe course of COVID-19 in obesity and diabetes mellitus, further studies are needed to assess the indicators of respiratory dysfunction, cardiometabolic, immune, inflammatory and thrombotic factors, as well as the characteristics of pharmacotherapy.
keywords: COVID-19 infection, obesity, diabetes mellitus
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50. Jie Chee, Y., Jia Huey Ng. S., Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus // Diabetes Res Clin Pract. – 2020. – № 164. – Р. 108166.
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50. Jie Chee, Y., Jia Huey Ng. S., Yeoh E. Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus // Diabetes Res Clin Pract. – 2020. – № 164. – 108166.
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