Impact of baseline metabolic abnormalities on clinical outcomes in patients with COVID-19

Objective. To examine in patients hospitalized with a diagnosis of COVID-19 the relationship between baseline lactate and glucose values and treatment outcomes. Patients and methods. On the basis of the N.A.Semashko Nizhny Novgorod Regional Clinical Hospital. A retrospective study with participation of 461 patients with confirmed diagnosis of COVID-19 was conducted at the N.A.Semashko Nizhny Novgorod Regional Clinical Hospital. The control group consisted of 237 patients who received Ringer's solution as infusion therapy from the moment of hospitalization. The study group included 224 patients who received 1.5% meglumine sodium succinate solution. During hospitalization, along with standard laboratory tests, lactate and plasma glucose were monitored. Results. The following were statistically determined: 1) if the initial lactate level rises by 1.0 mmol/l, the probability of lethal outcome in the control group increases 1.4 times compared to the study group (p = 0.001); the probability of transfer to ICU in the control group increases 1.5 times compared to the study group (p < 0.001); the probability of needing O2 on day 5–7 in the control group increases 1.7 times compared to the study group (p < 0.001); the duration of hospitalization in the control group increases 1.9 times compared to the study group (p = 0.019); 2) if the baseline glucose level rises by 1.0 mmol/l, the probability of transfer to the ICU in the control group increases 1.2 times compared to the study group (p < 0.001). Conclusion. Venous blood lactate is a predictor of an unfavorable course of COVID-19. The use of meglumine sodium succinate as a solution for infusion therapy in patients with moderately severe course of COVID-19 with initial hyperlactatemia and hyperglycemia improves the results of treatment due to a significant reduction in the risk of lethal outcome, the risk of transfer to ICU and the need for O2 on the 5th–7th day of hospitalization, as well as reducing the total duration of hospitalization. Key words: COVID-19, lactate, glucose, meglumine sodium succinate, lethality