PECULIARITIES OF ENDOTHELIAL DYSFUNCTION AND CAPILLARY BLOOD FLOW IN PATIENTS WITH COVID-19 CORONAVIRUS DISEASE AND CONCOMITANT TYPE 2 DIABETES MELLITUS

Abstract

The aim of the study was to investigate the indicators of endothelial dysfunction and capillary blood flow in patients with coronavirus disease (COVID-19) and concomitant type 2 diabetes mellitus.Materials and methods. We examined 60 patients with moderate and severe coronavirus disease (COVID-19): Group I (main) – 30 patients with coronavirus disease (COVID-19) with concomitant type 2 diabetes mellitus, mean age (66.70±1.47) years; Group II (comparison group) – 30 patients with coronavirus disease (COVID-19) without diabetes mellitus, mean age (60.13±2.21) years; control group (practically healthy) - 20 people. Nail capillaroscopy, determination of endothelin-1, D-dimer levels, and coagulation parameters were performed on the 2-3rd day after admission to the hospital.Results. In patients of both groups, a significant increase in the level of D-dimer, endothelin-1 was observed. The average values of D-dimer in patients of group I significantly exceeded the average values in patients of group II: 1543.20±254.01 ng FEU/ml and 522.74±39.45 ng FEU/ml respectively (p<0.001). During capillaroscopy in patients of group I, a high frequency of capillary branching (25.8%), bushy capillaries (25.8%) and tortuosity of capillaries (63.3%) was found, microthrombosis and microbleeding were observed more often. In patients of group II, the most common abnormalities were pericapillary edema (83.3%), capillary dilatation (36.7%), dilated and tortuous capillaries (13.3%), and hemosiderin deposits (36.7%). Conclusions. In patients with coronavirus disease (COVID-19) with concomitant type 2 diabetes mellitus, the levels of D-dimer and endothelin-1 indicated a more pronounced endothelial dysfunction. Changes in nail capillaroscopy indicating microvascular damage associated with COVID-19 were more pronounced in patients with concomitant type 2 diabetes.