Disturbances in Carbohydrate Metabolism as a Predictor of Decreased Quality of Life in Patients with Post-COVID Syndrome

Aim. To characterize the quality of life of patients with post-COVID syndrome depending on the presence of newly identified carbohydrate metabolism disorders (CMD) in the post-COVID period.

Design. Cross-sectional study.

Materials and methods. A total of 132 people with post-COVID syndrome were examined. The patients were divided into two groups: group 1 included 72 people with newly diagnosed impaired glucose tolerance (IGT) (n = 36) and type 2 diabetes mellitus (DM) (n = 36) in the post-COVID period, and group 2 included 60 people without concomitant CMD. The groups were comparable in terms of age and gender.

The average age of patients in group 1 was 61.0 [53.3; 66.5] years (with IGT — 58.5 [54.2; 62.5] years, with DM — 63.5 [51.0; 68.3] years), there were 26 men (36.1%), 46 women (63.9%); the average age of group 2 was 56.5 [51.0; 66.0] years, men — 24 (40.0%), women — 36 (60.0%). The duration of the course of post-COVID syndrome at the time of inclusion in the study in patients with IGT was 6.0 [4.8; 6.0] months, with type 2 diabetes — 6.0 [5.0; 6.0] months.

The presence of post-COVID syndrome was established on the basis of signs and symptoms that developed during and / or after COVID-19 infection, lasted more than 12 weeks and were not explained by an alternative diagnosis. The diagnosis of CMD (type 2 diabetes and IGT) was established in accordance with the Algorithms for specialized medical care for patients with diabetes mellitus (2021). The quality of life of patients was determined by conducting a questionnaire using the SF-36 questionnaire, containing 8 assessment scales: physical functioning, role physical functioning, vital activity, general health, mental health, social functioning, role emotional functioning, pain intensity, which form two parameters — psychological and physical components of health. The indicators of each scale vary from 0 to 100 points, and a higher result corresponds to a better quality of life of the subject. Patients filled out the questionnaire themselves, the analysis of the results was carried out using a specially developed computer program.

Results. The study groups were characterized by polymorbidity, in the 1st group, dyslipidemia (61.1%) and diseases of the urinary system (33.3%) were significantly more common. Patients with CMD had statistically significantly lower quality of life indicators according to the physical and role functioning scales, amounting to 55.00 and 25.00%, respectively. IGT and type 2 diabetes mellitus, first identified in individuals with post-COVID syndrome, had the most significant impact on the assessment of the physical component of health (33.29%), the indicator of the psychological component of health (52.36%) was comparable to that in the group without CMD (54.12%).

Conclusion. The combination of post-COVID syndrome and CMD significantly reduces a number of quality of life indicators in this category of patients. One of the significant predictors of deterioration in quality of life in individuals with post-COVID syndrome according to the physical and role functioning scales is CMD identified for the first time in the post-COVID period.

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