Abstract
AbstractAbstract Introduction: The World Health Organization (WHO) warns that viral diseases like COVID-19 pose a serious public health problem. The virus has caused millions of infections and deaths worldwide, including in Libya. The clinical features are similar to those of SARS and MERS, with varying degrees of severity depending on age, comorbid conditions, and basal metabolic index. Patients suffering from chronic health conditions are more likely to suffer further complications and the risk of death. The majority of deaths occur in the elderly as well as any age group with the presence of chronic diseases such as Diabetes Mellitus (DM), hypertension, chronic lung conditions, chronic kidney disease, cardiovascular disease, and other immunocompromised individuals. Hispanic ethnic minority groups and those with diabetes have a high risk of infection and high mortality rates. The history of diabetes and hyperglycemia are independent predictors of mortality and morbidity, and controlling diabetes can lead to good regulation of blood sugar to strengthen the immune system and reduce the severity of the disease. The aim of this study is to assess the effect of COVID-19 on glycemic control and identify the changes in biochemical and hematological parameters in subjects with type 2 diabetes at Imitiga Medical Isolation Center. Materials and methods: The study is a cross-sectional observational study on 135 COVID-19 patients with T2DM and 31 non-diabetics recruited from the Medical Preventive Hospital, Imitiga. The study was conducted from December 2021 to April 2022, and patients were randomly sampled using a nonprobability convenience sampling method. Data was collected through questionnaires containing personal and medical information, symptoms, duration of diabetes, drug history, past medical history, and vaccinations. Laboratory tests were conducted within 24 hours of hospital admission, including SARS-CoV-2 RNA isolation and amplification using qRT-PCR kits. Blood samples were collected from participants after fasting for 12 hours and analyzed for CBC, HBA1c, FBS, and FBS tubes. The samples were labeled by serial number and name of patients, and arterial blood gases were measured by an ABL800 BASIC ABG Machine Blood Gas Analyzer. All data was checked by a team of trained physicians. Ethical approval and informal consent were taken from patients regarding research. Results: showed a total of 135 participants (104 diabetics, 31 non-diabetics), (71 female, 64 male) were registered. The average age of participants was 64.2Â ± 5.3 (1.35). The prevalence of females was 55(52.9%), 16(51.6%), and the prevalence of males was 49(47.1%), and 15(48.4%) among diabetic and non-diabetics respectively, where patients infected by COVID-19 complained of mild symptoms was 17(16.3%), moderate symptoms were 34(32.7%), and sever symptoms was 53(51.0%) among diabetic patients. The prevalence of diabetic patients with no history of other chronic was 34(26.7%) and prevalence with other diseases was 19(18.3%), the prevalence of vaccinated patients was 16(15.3%), and the prevalence of non-vaccinated was 88 (84.7%) among diabetics. The prevalence of oral agents was 21(20.1%), Insulin was 62(59.6%), off-treatment was 2(1.9%), and patients with no treatments was 19(18.3%), the prevalence of diabetics with duration less than 5 years was 7(6.7%), and patients with duration of diabetics 5 to 10 years was 3(2.9%), and patients with more than 10 years was 75(72.1%), and patients whom the new diagnosis was 19(18.3%). Statistically significant differences between FBS, RBS, HgA1c between diabetics and non-diabetic patients, and among differences in duration of diabetes Miletus only in FBS, there were no significant differences between FBS, RBS, HgA1c between the type of management diabetic patients, in relation gender, the severity of symptoms, other comorbidities, and vaccination. The number and percentage of infected patients induced hyperglycemia were 97 (93.3%), and 19(61.3%) among diabetic and non-diabetic respectively, The normal Hemoglobin A1C levels were 11(1.6%), controlled were 48(46.1%) and uncontrolled were 45(43.3%) in diabetic cases, and in non-diabetic patients classified normal HBA1C were 11(1.6%) and pre-diabetic patients as HBA1C were 12(38.7%), there was no significant difference in ABG, LFT, RFT, CBC, and lipid profile function between diabetics and non-diabetic patients. Conclusion: This study showed COVID-19-induced hyperglycemia among diabetic patients, whereas there were changes in arterial blood gases, liver function, renal disturbances, electrolytes, and hematological changes. These findings emphasize the need for close follow-up and management of diabetic patients when they catch the infection Keywords: COVID-19; Glycemic control; Type 2 diabetes; Imitiga; Tripoli; Libya