Consequences of COVID-19: prediabetes and type 2 diabetes mellitus

Studies at the Research Laboratory for Novel Coronavirus Infection and Post-COVID Syndrome of the WCRC for Personalized Medicine, conducted in patients in the early and late post-COVID-19 periods, revealed a high incidence of carbohydrate metabolism disorders in the form of prediabetes and newly diagnosed type 2 diabetes mellitus. The results were used to elucidate the pathogenetic mechanisms of these disorders. Thus, studies of pancreatic autopsy material from patients who died during the acute phase of COVID-19 revealed the expression of SARS-CoV-2 proteins and ACE2 and DPP4 virus carrier proteins in islets of Langerhans cells. In addition, a double-labeling immunofluorescence assay showed co-localization of SARS-CoV-2 spike protein, DPP4 and ACE2 with insulin.

The data obtained confirm the possibility of a direct cytotoxic effect of the SARS-CoV-2 virus on pancreatic β-cells, which can be considered as one of the mechanisms for the development of carbohydrate metabolism disorders in patients both in the acute period of COVID-19 and in the post-COVID period. Expanding the knowledge of the pathogenesis of disorders associated with a viral disease in clinical practice will contribute to the choice of a personalized approach in the treatment of patients.