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Half of COVID-19 hospitalized patients have persistent hyperglycemia?
Half of COVID-19 hospitalized patients have persistent hyperglycemia? Diabetes will usher in an outbreak? Half of COVID-19 hospitalized patients have symptoms of persistent hyperglycemia.
Since the outbreak of the COVID-19 epidemic, it has continuously refreshed human’s understanding of the virus. As a “flying disaster” for the entire human race, the field and scope of its impact have also become larger and larger. Obviously, the COVID-19 pandemic has caused immeasurable losses to the world economy and profoundly affected the social order of mankind.
The receptor for the new coronavirus, ACE2, is a receptor protein widely distributed in the human body, mainly in organs and tissues such as the respiratory tract, intestines, kidneys, heart, and testes. Therefore, the new coronavirus infection will not only bring illness and death, but also cause other complications, and cause sequelae of different degrees and symptoms after the patient recovers, and these sequelae may exist for a long time, so researchers call it ” Long COVID” (long COVID). The long-term existence of the COVID-19 has greatly affected the physical fitness and working ability of the rehabilitation patients.
Recently, researchers from the University of Milan, Italy and Harvard Medical School in the United States published a research paper entitled: Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection in Nature Metabolism.
The study studied 551 COVID-19 hospitalized patients in Italy and found that 46% of them had elevated blood sugar, and they did not have any previous medical history or diabetes problems. Follow-up studies have found that after half a year of recovery, 35% of these patients with elevated blood sugar still have symptoms of high blood sugar.
It was further discovered that the regulation of glucose metabolism in these patients with COVID-19 has changed, with insulin resistance and abnormal cytokine expression profiles, even in patients with COVID-19 with normal blood sugar.
The research team said that this study shows that COVID-19 is related to abnormal glucose metabolism regulation and may persist even after recovery. Persistent high blood sugar is a new long-term health problem for patients with COVID-19. Therefore, it is necessary to take further measures for those long-term patients with COVID-19. Metabolism check.
High blood sugar persists after infection
The research team evaluated the health of 551 patients with COVID-19 who were hospitalized in Italy from March to May 2020. The follow-up period included six months after admission. It was found that 46% of the patients had elevated blood sugar, and they had no previous medical history or diabetes problems. Compared with patients with no signs of abnormal blood sugar, patients with hyperglycemia have more serious clinical problems:
Longer hospital stay; more severe clinical symptoms; higher oxygen demand; higher ventilation demand; more need for intensive care treatment.
Hormone level imbalance
In order to learn more, the research team is equipped with glucose sensors to monitor blood glucose changes in real time when all patients are admitted to the hospital. Over time, researchers have found many abnormalities in the regulation of glucose metabolism in patients with hyperglycemia.
The research team also found that patients with hyperglycemia have abnormal hormone levels. They have severe hyperinsulinemia, produce too much insulin, have abnormal levels of insulin precursors, and markers of impaired pancreatic β-cell function.
This shows that the pancreatic endocrine function of these COVID-19 hospital patients is abnormal, and it continues for a long time after recovery.
Inflammation caused by excess cytokines
In addition, the research team also found that the number of inflammatory cytokines (including IL-6, etc.) in these patients with high blood sugar was also severely abnormal. Therefore, the research team believes that blocking IL-6 and other cytokines may be effective in restoring pancreatic islet β cells in patients, and facts have proved that it is indeed the case. Compared with patients who did not receive drug treatment, they received anti-IL-6 therapy (tocilizumab) The treated patients had greater improvements in blood sugar control.
Is the wave of diabetes coming?
Although the abnormal glucose metabolism of some patients with COVID-19 disease has decreased over time after recovery, 35% of them still have symptoms of hyperglycemia for more than half a year.
It is reported that this is the first study to show that the new coronavirus has a direct impact on the pancreas, indicating that the pancreas is a target of the new coronavirus, which not only causes acute symptoms during hospitalization, but may also affect the long-term health of these patients.
In terms of treatment, the question of how to care for patients with abnormal blood sugar related to the COVID-19 still exists. Should patients only use anti-diabetic drugs such as insulin sensitizers, or should they use anti-inflammatory drugs such as tocilizumab and other drugs?
If you continue to target and block insulin, it will cause strong chronic inflammation and may lead to chronic damage, so larger studies are needed to test anti-diabetic and anti-inflammatory treatments.
Researchers said that tCOVID-19 has caused nearly 200 million infections worldwide, among which the number of hospitalized patients is undoubtedly a huge number. The damage to their pancreas by the COVID-19 virus is very likely to lead to a substantial increase in the next diabetes population.
(source:internet, reference only)