(DCP079) PANCREATIC BETA-CELL FUNCTION AND ECTOPIC FAT DEPOSITION 9-18 MONTHS AFTER A MILD COVID-19 EPISODE

Background: An increased risk of newly diagnosed diabetes and antihyperglycemic agents use has been reported after a COVID-19 infection. Metabolic mechanisms linking COVID-19 to diabetes remain unknown, but could involve insulin secretion through entry of SARS-CoV-2 in pancreatic cells. We hypothesized that individuals after mild COVID have decreased insulin secretion for similar ectopic fat deposition.

METHODS AND RESULTS: We recruited 8 participants with high waist circumference or BMI >30 kg/m2 who tested positive for a mild COVID-19 infection 9-18 months (n= 6) before screening and 2 controls matched for age, sex, and BMI who never tested positive for COVID-19 (Final sample size target n=60). We assessed plasma glucose, insulin, and c-peptide concentrations at times 0,10,20,30,60,90,120,180 minutes post 75g oral glucose tolerance test (OGTT). We used oral minimal modeling to estimate post-OGTT dynamic (PhiD), static (Phis) and total (Phitot) insulin secretion indices. We assessed hepatic and pancreatic fat fractions using a mDixon-Quant protocol on a 3.0T Philips MRI scanner. Results are presented as median[IQR25-75%] and p values are from Mann-Whitney U tests between groups. These are preliminary results from eight participants. There were no differences between the control and post-COVID groups for age (41[38-44] vs 43[34-51] years, p=0.87), BMI (30[29-30] vs 31[29-32] kg/m2, p=0.4), sex (50% vs 50% male), and waist circumference (96[92-100] vs 98[92-112] cm, p=0.62). There was a trend towards higher 120 min post-OGTT glucose in the post-COVID group compared to controls (7.0[6.2-7.0] vs 5.7[5.0-6.3] mmol/L, p=0.15). There were no differences in fasting glucose, post-OGTT iAUC glucose, post-OGTT iAUC c-peptide, Phis and Phitot (figure 1 and 2). PhiD (841[626-1381] vs 362[213-512] 10-9, p=0.18, figure 2) was higher in in the post-COVID vs control group, without statistical significance. Hepatic and pancreatic fat fraction were comparable between groups.

Conclusion: We hypothesized alteration in insulin secretion in individuals with abdominal adiposity who had a mild COVID-19 and our very preliminary results seem to show instead a trend toward higher insulin secretion. Relation with insulin resistance and ectopic fat and an increased number of participants will be in importance to interpret these results.