SARS-COV-2 infection outcomes in patients with congenital generalized lipodystrophy

• Published in: Diabetology and metabolic syndrome 2021-06, Vol.13 (1), p.1-65, Article 65
• Main Authors: Madeira, Mayara Ponte, Freire, Erika Bastos Lima, Fernandes, Virginia Oliveira, Lima, Grayce Ellen da Cruz Paiva, Melo, Ivana da Ponte, Montenegro, Ana Paula Dias Rangel, Freire, José Ednésio da Cruz, Moreira-Nunes, Caroline de Fátima Aquino, Montenegro, Raquel Carvalho, Colares, Jeová Keny Baima, Montenegro Junior, Renan Magalhães
• Format: Article
• Language: English
• Subjects: Analysis; Antibodies; Asymptomatic; Body fat; Cardiovascular disease; Care and treatment; Cholesterol; Comorbidity; Congenital diseases; Congenital generalized lipodystrophy; Coronaviruses; COVID-19; Diabetes; Diabetes mellitus; Diabetes therapy; Diarrhea; Fever; Genetic disorders; Hypertension; Infection; Infections; Insulin; Insulin resistance; Lipodystrophy; Medical research; Medicine, Experimental; Metabolism; Mutation; Nausea; Obesity; Patient outcomes; Patients; Prognosis; SARS-COV-2; Severe acute respiratory syndrome coronavirus 2; Triglycerides; Viral antibodies
• ISSN: 1758-5996; 1758-5996
• DOI: 10.1186/s13098-021-00680-1

Background A new strain of human coronavirus (HCoV) spread rapidly around the world. Diabetes and obesity are associated with a worse prognosis in these patients. Congenital Generalized Lipodystrophy (CGL) patients generally have poorly controlled diabetes and require extremely high doses of insulin. There is no documentation in the literature of cases of COVID in CGL patients. Thus, we aimed to evaluate the prevalence of SARS-CoV-2 infection in CGL patients, and the association of their clinical and metabolic characteristics and outcomes. Methods This is a cross-sectional study carried out between July and October 2020. Clinical data collected were respiratory or other flu-like symptoms, need of hospitalization in the last three months, CGL comorbidities, and medications in use. Cholesterol, triglycerides, glycohemoglobin A1c levels, anti-SARS-CoV-2 antibodies and nasopharyngeal swab for RT-qPCR were also obtained in all CGL patients. Mann-Whitney U test was used to analyze the characteristics of the participants, verifying the non-adherence of the data to the Gaussian distribution. In investigating the association between categorical variables, we used Pearson's chi-square test and Fisher's exact test. A significance level of 5% was adopted. Results Twenty-two CGL patients were assessed. Eight subjects (36.4%) had reactive anti-SARS-CoV-2 antibodies. Only one of these, also presented detectable RT-qPCR. Five individuals (62.5%) were women, median age of 13.5 years (1 to 37). Symptoms like fever, malaise, nausea, diarrhea and chest pain were present, and all asymptomatic patients were children. All subjects had inadequate metabolic control, with no difference between groups. Among positive individuals there was no difference between those with AGPAT2 (75%) and BSCL2 gene mutations (25%) (p 0.05). No patient needed hospitalization or died. Conclusions We described a high prevalence of SARS-CoV-2 infection in CGL patients with a good outcome in all of them. These findings suggest that at least young CGL patients infected by SARS-COV-2 are not at higher risk of poor outcome, despite known severe metabolic comorbidities. Keywords: SARS-COV-2, COVID-19, Congenital generalized lipodystrophy, Lipodystrophy, Diabetes, Insulin resistance