Abstract
Introduction.
COVID-19-associated lung injury (COVID-19-ALI) is characterized by diffuse alveolar damage. The manifestation of long-term comorbid complications of this infection is particularly relevant in patients with type 2 diabetes mellitus (T2DM).
Aim.
To evaluate the association of hemostasis parameters with acute phase severity and the subsequent onset of comorbidities in patients with COVID-19-ALI and T2DM.
Materials and methods.
The study examined 108 hospitalized patients with COVID-19-ALI (52 patients without T2DM and 56 with concomitant T2DM), as well as 22 healthy volunteers comparable in age and sex. During a 36-month follow-up, the incidence of the following comorbidities was evaluated: arterial hypertension, chronic cerebral ischemia, hypo- and hyperthyroidism, cardiac arrhythmias, exertional angina, and obesity. Results. The combination of COVID-19-ALI and T2DM was associated with profound disorders of hemostasis and fibrinolysis. A model was developed to evaluate the probability of a severe acute phase based on a complex of coagulation parameters, D-dimer, and the FGB gene rs1800790 polymorphism (AUC= 0.92). To assess the risk of long-term pathology onset at 36 months, an algorithm based on an isolated thrombin time parameter was proposed (AUC = 0.79).
Conclusion.
A pronounced imbalance of the blood coagulation system in COVID-19-ALI and T2DM is associated with acute status severity and long-term prognosis. The developed software is applicable for objectifying patient status upon admission and stratifying the risk of long-term outcomes.