Effect of hyperglycemia on the immune function of COVID-19 patients with type 2 diabetes mellitus: a retrospective study

PeerJ. 2022 Dec 16:10:e14570. doi: 10.7717/peerj.14570. eCollection 2022.

Abstract

Purpose: To analyze the clinical characteristics and immune function parameters and to explore the effect of hyperglycemia on the immune function in patients with Corona Virus Disease 2019 (COVID-19) with type 2 diabetes mellitus (T2DM).

Methods: This retrospective study included patients with COVID-19 with T2DM hospitalized in Renmin Hospital of Wuhan University between January 31, 2020, and February 10, 2020. The clinical data were collected and patients were divided into a well-controlled group (blood glucose 3.9-10.0 mmol/L) and a poorly-controlled group (blood glucose >10.0 mmol/L). The differences in routine blood tests, peripheral lymphocyte subsets, humoral immune components, C-reactive protein (CRP) level, and cytokines were compared, and the correlation between blood glucose and immune parameters as well as the severity of the disease was analyzed.

Results: A total of 65 patients with COVID-19 and T2DM were included in the final analysis. Compared with the well-controlled group, patients in the poorly-controlled group had decreased lymphocytes, CD16+ 56+ NK cells, CD3+ T cells, CD8+ T cells and increased neutrophil percentage, IL-6 levels, CRP levels and serum concentration of IgA. Blood glucose was inversely correlated with CD16+ 56+ NK cells, CD3+ T cells, CD4+ T cells, and CD8+ T cells and positively correlated with IL-6 and CRP levels. There was a positive correlation between blood glucose and the severity of the COVID-19.

Conclusion: Hyperglycemia will aggravate the immune dysfunction of COVID-19 patients with T2DM and affect the severity of COVID-19.

Keywords: Corona Virus Disease 2019; Hyperglycemia; Immune function; Type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • CD8-Positive T-Lymphocytes
  • COVID-19*
  • Diabetes Mellitus, Type 2* / complications
  • Humans
  • Hyperglycemia*
  • Immunity
  • Interleukin-6
  • Retrospective Studies

Substances

  • Blood Glucose
  • Interleukin-6

Grants and funding

The work was supported by the Zhejiang University special scientific research fund for COVID-19 prevent and control (grant number 2020XGZX015), the National Natural Science Foundation of China (grant number 81900749), and the Nature Science Foundation of Hubei province (grant number 2018CFB150). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.