The role of type 2 diabetes in the escalation of platelet dysfunction in patients with covid-19associated lung damage

Abstract

Changes in the functional activity of platelets in patients with COVID-19 and type 2 diabetes mellitus are widely known, but the mechanism of platelet dysfunction in the combination of these diseases has not been studied. The aim of the work is to investigate the effect of the presence of type 2 diabetes mellitus on the aggregation and content of products of oxidative degradation of lipids and proteins in platelets in patients with severe COVID-19-associated lung disease. Methods. The study involved patients with COVID-19 (n = 55) aged 51 to 75 years with more than 50% lung tissue damage. Depending on the presence or absence of type 2 diabetes mellitus, patients were divided into 2 groups. The control group consisted of practically healthy people (n = 24), matched by sex and age with patients with COVID-19. In all individuals, the number of platelets in the blood, platelet aggregation induced by ADP, collagen, adrenaline and ristomycin, the content of lipid peroxidation products in the hepatic and isopropanol phases of the extract, and protein oxidative modification products (PMP) products in spontaneous and metal-induced detection modes were studied. The data obtained were analyzed using the IBM SPSS Statistics v. 23. Results. In patients with severe COVID-19-associated lung disease, the number of platelets in the blood does not change significantly, but platelet aggregation induced by collagen and ristomycin is accelerated; in platelet-rich plasma, the total content of OMP products, the level of primary and secondary LPO products in platelets increases. In patients with COVID-19-associated lung injury in combination with type 2 diabetes, the number of platelets in the blood is significantly reduced, platelet aggregation is accelerated, induced by ADP, collagen, adrenaline, and ristomycin; there is a significant increase in the level of early and late PMP products in the spontaneous and metal-induced detection mode in platelets, the level of primary, secondary and final LPO markers in platelets increases in the heptane and isopropanol phases of the lipid extract. It was found that in patients with COVID-19-associated lung injury, including those associated with type 2 diabetes, platelet aggregation induced by ADP, collagen, adrenaline, and ristomycin accelerates as the content of oxidative degradation products of lipids and proteins in them increases. The presence of type 2 diabetes in patients with COVID-19-associated lung damage doubles the number of direct links of moderate and noticeable strength between platelet aggregation and the content of LPO and PMP products in them.