Carbohydrate and lipid metabolism in children after coronavirus disease: Observational study

Background. Six months after coronavirus disease (COVID-19), more than half of the children have various clinical manifestations of post-covid syndrome. In adult patients without a history of diabetes mellitus, cases of carbohydrate metabolism disorders against the background of COVID-19 and in the long term after the disease have been described. Coronavirus infection in adult patients with lipid disorders is associated with a high risk of severe COVID-19. A 12-year follow-up of patients with severe acute respiratory syndrome (SARS) caused by SARS-CoV showed that they were at an increased risk of developing dyslipidemia. For patients who have undergone SARS-CoV-2, there are no such data due to the short follow-up period. Studies in children evaluating the impact of coronavirus disease on the state of carbohydrate and lipid metabolism are isolated and contradictory.

Aim. To compare indicators of carbohydrate and lipid metabolism in children after a coronavirus disease with a control group of healthy peers without a history of COVID-19.

Materials and methods. The study included 108 children aged 3 to 17 years, divided into two groups. The study group included 50 children (mean age 12.0 [7.4; 14.5] years) after a coronavirus disease. The average follow-up period after the disease was 6 months (from 3 to 12 months). The control group consisted of 58 healthy peers (mean age 12.5 [7.5; 15.1] years) without a history of COVID-19. All children underwent an assessment of the level of glucose in the blood serum, lipid metabolism and the calculation of the triglyceride-glucose index (TyG index).

Results. The frequency of impaired fasting glycemia in children after a coronavirus disease was 2% and was comparable to the control group of healthy peers without a history of COVID-19. The TyG indices in the study groups did not differ significantly (4.46 [4.11; 4.65] vs 4.33 [4.0; 4.47]; p=0.37). None of the children included in the study showed an increase in the TyG index to values corresponding to the criterion of insulin resistance. An assessment of the state of lipid metabolism also did not reveal significant differences in the levels of total cholesterol, LDL, HDL and triglycerides, depending on the presence of a history of coronavirus disease.

Conclusion. In children six months (3–12 months) after coronavirus disease, there was no increase in the frequency of impaired fasting glycemia and insulin resistance compared to healthy peers without a history of COVID-19.