Covid-19 Impact on Blood Sugar Levels and Renal Function Deterioration: A Comparative Study

Abstract

Covid-19 is an infectious disease triggered by the SARS-CoV-2 virus. Its first emergence was documented in December 2019 in Wuhan, China, leading to a global spread and a pandemic declaration. Covid-19 symptoms usually include fever, cough, headache, fatigue, respiratory problems, and loss of sensation. Diabetes is a medical condition characterized by insufficient insulin production from the pancreas. According to previous studies, there is a two-way relationship between diabetes and Covid-19. On the one hand, it was found that diabetes leads to a fourfold increase in the risk of infection with Covid-19 in the average person. On the other hand, infection with Covid-19 can cause diabetes in patients who do not have diabetes. Renal dysfunction is a condition in which the kidneys are unable to remove waste macromolecules from the blood serum and require medical support. According to previous studies, more than one-third of patients infected with Covid-19 had acute renal dysfunction, and 15% of those infected are known to be on dialysis. Samples were collected from patients, which numbered 120 samples, the number of normal samples was 60, and the number of abnormal samples was 60. The following analyses were performed for all samples (PCR. Ferriten, LDH, D.Dimer, S.Creatinine, B. Urea, Albumin, S, Glucose ). In Covid-19, the following four analyses were chosen to diagnose the presence of the virus in the body: PCR, Ferriten, LDH, and D.Dimer. In diabetes mellitus, the following analyses were selected for this disease. These analyses are among the most accurate analyses for diagnosing diabetes which is: S, Glucose. In renal failure, the three most important analyses were chosen to diagnose the efficiency of the work and functions of the kidneys creatinine, B.Urea, and Albumin. When samples were tested by Independent T-test regarding ferritin, LDH D-dimer, and FBS, there were no significant differences between samples that were affected by Covid-19 and samples that were not infected by Covid-19. While Creatinine, Urea, and Albumin, there are significant differences between samples that are affected by Covid-19 and samples that are not infected by Covid-19. Thus, there is a relationship between Covid-19, diabetes, and kidney function impairment, and this relationship whenever there is a strong infection with the Covid-19 virus may result in kidney function impairment or diabetes.

Keywords

• Covid-19
• renal function
• diabetes
• PCR

Covid-19 impact on blood sugar levels and renal function deterioration: a comparative study

Abstract

COVID-19 is an infectious disease triggered by the SARS-CoV-2 virus. Its first emergence was documented in December 2019 in Wuhan, China, leading to a global spread and a pandemic declaration. COVID-19 symptoms usually include fever, cough, headache, fatigue, respiratory problems, and loss of sensation. Diabetes is a medical condition characterized by insufficient insulin production from the pancreas. According to previous studies, there is a two-way relationship between diabetes and Covid-19. On the one hand, it was found that diabetes leads to a fourfold increase in the risk of infection with Covid-19 in the average person. On the other hand, infection with Covid-19 can cause diabetes in patients who do not have diabetes. Renal dysfunction is a condition in which the kidneys are unable to remove waste macromolecules from the blood serum and require medical support. According to previous studies, more than one-third of patients infected with COVID-19 had acute renal dysfunction, and 15% of those infected are known to be on dialysis. Samples were collected from patients, which numbered 160 samples, the number of normal samples was 60, and the number of abnormal samples was 60. The following analyses were performed for all samples (PCR. Ferriten, LDH, D.Dimer, S.Creatinine, B. Urea, Albumin, S, Glucose ). In Covid 19, the following three analyses were chosen to diagnose the presence of the virus in the body: PCR, Ferriten, LDH, and D.Dimer. In diabetes mellitus, the following analyses were selected for this disease. These analyses are among the most accurate analyses for diagnosing diabetes which is: S, Glucose. In renal failure, the three most important analyses were chosen to diagnose the efficiency of the work and functions of the kidneys creatinine,B.UREA, and Albumin. When samples were tested by Independent T-test regarding ferritin, LDH D-dimer, and FBS, there were no significant differences between samples that were affected by COVID-19 and samples that were not infected by COVID-19. While Creatinine, Urea, and Albumin, there are significant differences between samples that are affected by COVID-19 and samples that are not infected by COVID-19. Thus, there is a relationship between Covid 19, diabetes, and kidney function impairment, and this relationship whenever there is a strong infection with the Covid 19 virus may result in kidney function impairment or diabetes. Null hypotheses There is no significant effect of COVID-19 on blood sugar levels (diabetes) and renal function impairment.

Keywords

• Covid-19
• renal function
• diabetes
• PCR
• CRP
• LDH
• D-dimer

References

1. [1] C. Huang et al., “Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China,” Lancet, vol. 395, no. 10223, pp. 497–506, Feb. 2020, doi: 10.1016/S0140-6736(20)30183-5.
2. [2] S. Su et al., “Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses,” Trends Microbiol., vol. 24, no. 6, pp. 490–502, Jun. 2016, doi: 10.1016/j.tim.2016.03.003.
3. [3] P. C. Y. Woo et al., “ICTV Virus Taxonomy Profile: Coronaviridae 2023,” J. Gen. Virol., vol. 104, no. 4, Apr. 2023, doi: 10.1099/jgv.0.001843.
4. [4] S. Ali, B. Bello, P. Chourasia, R. T. Punathil, Y. Zhou, and M. Patterson, “PWM2Vec: An Efficient Embedding Approach for Viral Host Specification from Coronavirus Spike Sequences,” Biology (Basel)., vol. 11, no. 3, p. 418, Mar. 2022, doi: 10.3390/biology11030418.
5. [5] A. J. Rodriguez-Morales et al., “History is Repeating Itself: Probable Zoonotic Spillover as the Cause of the 2019 Novel Coronavirus Epidemic,” Infez. Med., vol. 28, no. 1, pp. 3–5, 2020.
6. [6] O. M. Abdeldayem et al., “Viral outbreaks detection and surveillance using wastewater-based epidemiology, viral air sampling, and machine learning techniques: A comprehensive review and outlook,” Sci. Total Environ., vol. 803, p. 149834, Jan. 2022, doi: 10.1016/j.scitotenv.2021.149834.
7. [7] X. Yang et al., “Clinical Course and Outcomes of Critically Ill Patients With SARS-CoV-2 Pneumonia in Wuhan, China: a Single-Centered, Retrospective, Observational Study,” Lancet Respir. Med., vol. 8, no. 5, pp. 475–481, May 2020, doi: 10.1016/S2213-2600(20)30079-5.
8. [8] A. B. Bungum et al., “Risk of SARS-CoV-2 infection in healthcare workers with insufficient use of personal protective equipment in Denmark,” Ann. Work Expo. Heal., vol. 69, no. 1, pp. 96–103, Jan. 2025, doi: 10.1093/annweh/wxae075.

9. [9] N. van Doremalen et al., “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1,” N. Engl. J. Med., vol. 382, no. 16, pp. 1564–1567, Apr. 2020, doi: 10.1056/NEJMc2004973.
10. [10] V. F. McNeill, “Airborne Transmission of SARS-CoV-2: Evidence and Implications for Engineering Controls,” Annu. Rev. Chem. Biomol. Eng., vol. 13, no. 1, pp. 123–140, Jun. 2022, doi: 10.1146/annurev-chembioeng-092220-111631.
11. [11] E. A. Huhn, S. W. Rossi, I. Hoesli, and C. S. Göbl, “Controversies in Screening and Diagnostic Criteria for Gestational Diabetes in Early and Late Pregnancy,” Front. Endocrinol. (Lausanne)., vol. 9, Nov. 2018, doi: 10.3389/fendo.2018.00696.
12. [12] C. C. Olisah, L. Smith, and M. Smith, “Diabetes mellitus prediction and diagnosis from a data preprocessing and machine learning perspective,” Comput. Methods Programs Biomed., vol. 220, p. 106773, Jun. 2022, doi: 10.1016/j.cmpb.2022.106773.
13. [13] H. Kaminska et al., “Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis,” Acta Diabetol., vol. 58, no. 8, pp. 1101–1110, Aug. 2021, doi: 10.1007/s00592-021-01701-1.
14. [14] S. Gentile, F. Strollo, and A. Ceriello, “COVID-19 Infection in Italian People With Diabetes: Lessons Learned for Our Future (An Experience to be Used),” Diabetes Res. Clin. Pract., vol. 162, p. 108137, Apr. 2020, doi: 10.1016/j.diabres.2020.108137.
15. [15] R. Muniyappa and S. Gubbi, “COVID-19 Pandemic, Coronaviruses, and Diabetes Mellitus,” Am. J. Physiol. Metab., vol. 318, no. 5, pp. E736–E741, May 2020, doi: 10.1152/ajpendo.00124.2020.
16. [16] Y. R. Rastogi, A. Sharma, R. Nagraik, A. Aygün, and F. Şen, “The Novel Coronavirus 2019-Ncov: Its Evolution and Transmission Into Humans Causing Global COVID-19 Pandemic,” Int. J. Environ. Sci. Technol., vol. 17, no. 10, pp. 4381–4388, Oct. 2020, doi: 10.1007/s13762-020-02781-2.
17. [17] E. Esra Altuner, M. Bekmezci, R. N. E. Tiri, A. Aygun, and F. Sen, “A Review: Severe Treatments, Drug and Vaccine Studies For Coronavirus Disease (Covid-19),” J. Sci. Reports-C, vol. 3, no. 21–38, pp. 2717–8633, 2022.
18. [18] B. Li et al., “Prevalence and Impact of Cardiovascular Metabolic Diseases on COVID-19 in China,” Clin. Res. Cardiol., vol. 109, no. 5, pp. 531–538, May 2020, doi: 10.1007/s00392-020-01626-9.
19. [19] G. P. Fadini, M. L. Morieri, E. Longato, and A. Avogaro, “Prevalence and Impact of Diabetes Among People Infected With SARS-CoV-2,” J. Endocrinol. Invest., vol. 43, no. 6, pp. 867–869, Jun. 2020, doi: 10.1007/s40618-020-01236-2.
20. [20] S. R. Bornstein, R. Dalan, D. Hopkins, G. Mingrone, and B. O. Boehm, “Endocrine and Metabolic Link to Coronavirus Infection,” Nat. Rev. Endocrinol., vol. 16, no. 6, pp. 297–298, Jun. 2020, doi: 10.1038/s41574-020-0353-9.
21. [21] A. Remuzzi and G. Remuzzi, “COVID-19 and Italy: What Next?,” Lancet, vol. 395, no. 10231, pp. 1225–1228, Apr. 2020, doi: 10.1016/S0140-6736(20)30627-9.
22. [22] J. Zhou, Y. Wang, and R. Xu, “Association of COVID-19 infection and the risk of new incident diabetes: a systematic review and meta-analysis,” Front. Endocrinol. (Lausanne)., vol. 15, Aug. 2024, doi: 10.3389/fendo.2024.1429848.
23. [23] J. A. Kellum, P. Romagnani, G. Ashuntantang, C. Ronco, A. Zarbock, and H.-J. Anders, “Acute kidney injury,” Nat. Rev. Dis. Prim., vol. 7, no. 1, p. 52, Jul. 2021, doi: 10.1038/s41572-021-00284-z.
24. [24] S. Shrivastava, N. Srivastava, and M. Alfanso-Jaume, “Acute Renal Failure With Cocaine and SGLT-2 Inhibitor,” Am. J. Ther., vol. 26, no. 6, pp. e762–e763, Nov. 2019, doi: 10.1097/MJT.0000000000000929.
25. [25] E. A. J. Hoste, J. A. Kellum, R. Bellomo, and C. Ronco, “What Is Acute Kidney Injury?,” in Critical Care Nephrology, Elsevier, 2009, pp. 67–71.
26. [26] X. Luo, L. Jiang, B. Du, Y. Wen, M. Wang, and X. Xi, “A Comparison of Different Diagnostic Criteria of Acute Kidney Injury in Critically Ill Patients,” Crit. Care, vol. 18, no. 4, p. R144, 2014, doi: 10.1186/cc13977.
27. [27] I. N. Price and A. F. Wood, “Chronic Kidney Disease and Renal Replacement Therapy: an Overview for the Advanced Clinical Practitioner,” Br. J. Nurs., vol. 31, no. 3, pp. 124–134, Feb. 2022, doi: 10.12968/bjon.2022.31.3.124.
28. [28] A. Zabalza, A. Thompson, D. L. Rotstein, A. Bar-Or, and X. Montalban, “Multiple sclerosis and COVID-19: interactions and unresolved issues,” Lancet Neurol., vol. 24, no. 4, pp. 361–370, Apr. 2025, doi: 10.1016/S1474-4422(25)00006-7.
29. [29] A. et al. Zabalza, “Multiple sclerosis and COVID-19: interactions and unresolved issues,” Lancet Neurol., vol. 24, no. 4, Apr. 2025, Accessed: Apr. 29, 2025. [Online]. Available: https://www.thelancet.com/action/showCitFormats?doi=10.1016%2FS1474-4422%2825%2900006-7&pii=S1474-4422%2825%2900006-7.
30. [30] I.-W. Chen et al., “Association between COVID-19 and the development of chronic kidney disease in patients without initial acute kidney injury,” Sci. Rep., vol. 15, no. 1, p. 10924, Mar. 2025, doi: 10.1038/s41598-025-96032-4.
31. [31] A. Joseph, L. Zafrani, A. Mabrouki, E. Azoulay, and M. Darmon, “Acute Kidney Injury in Patients With SARS-CoV-2 Infection,” Ann. Intensive Care, vol. 10, no. 1, p. 117, Dec. 2020, doi: 10.1186/s13613-020-00734-z.
32. [32] Y. Cheng et al., “Kidney Disease is Associated With in Hospital Death of Patients With COVID-19,” Kidney Int., vol. 97, no. 5, pp. 829–838, May 2020, doi: 10.1016/j.kint.2020.03.005.
33. [33] S. Shyama, H. Vardhan, V. S. Ojha, R. Biswas, S. Ahmad, and A. Kumar, “Factors Affecting Mortality in COVID-19 Patients with Pre-Existing Chronic Kidney Disease,” Indian J. Nephrol., vol. 34, p. 643, Jun. 2024, doi: 10.25259/IJN_67_2024.
34. [34] Z. Varga et al., “Endothelial Cell Infection and Endotheliitis in COVID-19,” Lancet, vol. 395, no. 10234, pp. 1417–1418, May 2020, doi: 10.1016/S0140-6736(20)30937-5.
35. [35] H. Su et al., “Renal Histopathological Analysis of 26 Postmortem Findings of Patients With COVID-19 in China,” Kidney Int., vol. 98, no. 1, pp. 219–227, Jul. 2020, doi: 10.1016/j.kint.2020.04.003.
36. [36] M. L. Bach et al., “ACE2 and TMPRSS2 in human kidney tissue and urine extracellular vesicles with age, sex, and COVID-19,” Pflügers Arch. - Eur. J. Physiol., vol. 477, no. 1, pp. 83–98, Jan. 2025, doi: 10.1007/s00424-024-03022-y.
37. [37] T. Azim, A. H. Khan, F. Sadiq, S. A. S. Sulaiman, A. Khan, and Q. Ain, “Impact of COVID-19 on nephropathy in diabetes mellitus type–II patients: a systematic literature review and meta-analysis,” BMC Nephrol., vol. 25, no. 1, p. 399, Nov. 2024, doi: 10.1186/s12882-024-03821-6.
38. [38] A. Gheware et al., “ACE2 protein expression in lung tissues of severe COVID-19 infection,” Sci. Rep., vol. 12, no. 1, p. 4058, Mar. 2022, doi: 10.1038/s41598-022-07918-6.
39. [39] R. Chowdhury et al., “Dynamic interventions to control COVID-19 pandemic: a multivariate prediction modelling study comparing 16 worldwide countries,” Eur. J. Epidemiol., vol. 35, no. 5, pp. 389–399, May 2020, doi: 10.1007/s10654-020-00649-w.
40. [40] K. Kaushal et al., “Serum Ferritin as A Predictive Biomarker in COVID-19. A Systematic Review, Meta-Analysis and Meta-Regression Analysis,” J. Crit. Care, vol. 67, pp. 172–181, Feb. 2022, doi: 10.1016/j.jcrc.2021.09.023.
41. [41] C. Mattiuzzi and G. Lippi, “Real World Effectiveness of COVID-19 Vaccination Among Children in Italy,” Int. J. Infect. Dis., vol. 122, pp. 70–71, Sep. 2022, doi: 10.1016/j.ijid.2022.05.045.
42. [42] Y. Li et al., “Acute Cerebrovascular Disease Following COVID-19: A Single Center, Retrospective, Observational Study,” Stroke Vasc. Neurol., vol. 5, no. 3, pp. 279–284, Sep. 2020, doi: 10.1136/svn-2020-000431.
43. [43] I. Serin, A. Ulusoy, M. I. Onar, and M. H. Dogu, “COVID-19 Pneumonia or Hypereosinophilic Syndrome?,” J. Med. Cases, vol. 11, no. 12, pp. 400–402, 2020, doi: 10.14740/jmc3587.
44. [44] S. A. Raza, W. Qazi, K. A. Khan, and J. Salam, “Social Isolation and Acceptance of the Learning Management System (LMS) in the time of COVID-19 Pandemic: An Expansion of the UTAUT Model,” J. Educ. Comput. Res., vol. 59, no. 2, pp. 183–208, Apr. 2021, doi: 10.1177/0735633120960421.
45. [45] S. Shabbir, M. H. Raza, M. Arshad, and M. J. Khan, “The Interplay Between the Immune System and SARS-CoV-2 in COVID-19 Patients,” Arch. Virol., vol. 166, no. 8, pp. 2109–2117, Aug. 2021, doi: 10.1007/s00705-021-05091-1.
46. [46] M. A. Zamzami et al., “Carbon Nanotube Field-Effect Transistor (CNT-FET) Based Biosensor for Rapid Detection of SARS-CoV-2 (COVID-19) Surface Spike Protein S1,” Bioelectrochemistry, vol. 143, p. 107982, Feb. 2022, doi: 10.1016/j.bioelechem.2021.107982.
47. [47] F. Ok, O. Erdogan, E. Durmus, S. Carkci, and A. Canik, “Predictive Values of Blood Urea Nitrogen/Creatinine Ratio and Other Routine Blood Parameters On Disease Severity and Survival Of COVID‐19 Patients,” J. Med. Virol., vol. 93, no. 2, pp. 786–793, Feb. 2021, doi: 10.1002/jmv.26300.
48. [48] K. Chan, S. Lim, H. Shaaban, G. Guron, and J. Slim, “Persistent Hypercoagulable State in COVID-19: A Case Series of COVID-19 Associated Pulmonary Embolism,” J. Glob. Infect. Dis., vol. 13, no. 1, p. 38, 2021, doi: 10.4103/jgid.jgid_180_20.
49. [49] K. H. Chan et al., “Coronavirus Disease 2019 (COVID-19) and Ischemic Colitis: An Under-Recognized Complication,” Am. J. Emerg. Med., vol. 38, no. 12, pp. 2758.e1-2758.e4, Dec. 2020, doi: 10.1016/j.ajem.2020.05.072.
50. [50] E. Durmus and F. Ok, “Flank Pain as a Symptom of COVID-19,” Urology, vol. 148, pp. e13–e14, Feb. 2021, doi: 10.1016/j.urology.2020.11.007.
51. [51] A. Cheng et al., “Diagnostic Performance of Initial Blood Urea Nitrogen Combined With D-Dimer Levels for Predicting In-Hospital Mortality in COVID-19 Patients,” Int. J. Antimicrob. Agents, vol. 56, no. 3, p. 106110, Sep. 2020, doi: 10.1016/j.ijantimicag.2020.106110.
52. [52] R. Pranata et al., “Proton Pump Inhibitor on Susceptibility to COVID-19 and its Severity: A Systematic Review and Meta-Analysis,” Pharmacol. Reports, vol. 73, no. 6, pp. 1642–1649, Dec. 2021, doi: 10.1007/s43440-021-00263-x.