P226 DYNAMO Covid-19. Dynamic assessment of multi organ level dysfunction in patients recovering from Covid-19: insulin resistance and metabolic flexibility

• DOI: 10.1136/thorax-2022-btsabstracts.358
• Publication Date: 2022-12-17T05:55:08Z
• Authors: A Gutpa; R Nicholas; JJ McGing; O Mougin; CR Bradley; AV Nixon; JE Mallinson; J Bonnington; TM McKeever; IP Hall; JM Lord; RA Evans; PL Greenhaff; ST Francis; CE Bolton

<h3>Introduction</h3> Initial acute hyperglycaemia is reported in patients during hospitalisation with SARS-CoV-2 infection. However, it unclear what maladaptations occur long-term. Whole-body insulin sensitivity and metabolic flexibility were assessed alongside whole-body regional fat content to provide insight of health status recovering patients. <h3>Methods</h3> Adults recruited at 5–7 months following hospital discharge for severe SARS-Cov2 infection (n=21), along control volunteers (n=10) a similar age, gender, ethnicity BMI. Indirect calorimetry was conducted before an oral glucose tolerance test (OGTT) assess [Δ respiratory exchange ratio (RER) from fasting peak]. In conjunction, regular arterialised venous bloods taken retrograde cannula over 3-hour period determine blood serum insulin. At separate visits (within 2 weeks), dual energy X-ray absorptiometry measured fraction, whilst ¹H Magnetic Resonance Spectroscopy (MRS) quantified intra extra-myocellular lipid fractions (IMCL EMCL) the thigh muscle MR Imaging using mDIXON scan identified subjects fatty liver (fat fraction&gt;5.6%). Average daily activity 7-day accelerometer. Data are Non-parametric: median(IQR), parametric: mean(SD) categorical: n(%). <h3>Results</h3> The OGTT response greater (P) than controls (C) (figure 1b), but 1a) RER responses [P: 0.08(0.07) vs C: 0.13(0.07), p=0.1] not. Patients had lower average step count 3,626(2,385–6,337) steps 7,670(5,111–10,074), p=0.07] more 13(68%) 3(30%), p=0.048]. fraction 38.3(6.8)% 37.4(9.6)%, p=0.8] IMCL:EMCL 0.45(0.28) 0.67(0.42), not different. Physical independent factors resistance multivariate regression model. <h3>Conclusion</h3> Covid-19 have worse compared controls, flexibility. inactivity adiposity may play role these observations. <h3>Funding</h3> NIHR Nottingham BRC (NoRCoRP), PHOSP UKRI, Hospitals Charity, University alumni donation.