Diabetes in the COVID-19 pandemic era

Abstract

OBJECTIVE:To analyze the association between patients with diabetes mellitus and the increased severity and its complications that arise with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.METHODS: This is a complementary review of literature in which 14 articles published in 2020 were selected. These reviewed articles were written in both Portuguese and English available in the SciELO and PubMed databases. This review also involved searching on websites of international and national organizations in order to gather information published by these bodies about diabetic population and coronavirus disease (COVID-19)-infected individuals. DISCUSSION:The presence of comorbidities in SARS-CoV-2-infected individuals causes an increase in the expression level of angiotensinconverting enzyme 2, facilitating the entry of the virus into the cell. Diabetes causes metabolic and vascular changes, thus weakening the immune system through the inhibition of the innate immune system and the secretion of various inflammatory cytokines. This hyperinflammation can lead to multiple organ failure. The interaction between this comorbidity and COVID-19 can worsen preexisting diabetes or predispose the onset of diabetes in non-diabetic individuals. CONCLUSIONS: Diabetes mellitus is related to the increased severity and complications of COVID-19. The association between diabetes and COVID-19 creates a devastating double pandemic, as it worsens the prognosis of COVID-19.

Associação entre a hiperglicemia e os piores desfechos em pacientes internados por COVID-19 em uma unidade de terapia intensiva em Maceió

“…Um fator de risco importante para maior mortalidade observado na pesquisa foi Diabetes Mellitus (DM) diagnosticado previamente, o qual teve uma correlação com o número de óbitos, representando 70% deste grupo. Essa correlação pode ser justificada devido às alterações metabólicas e vasculares, que ocorrem em pacientes com DM, responsáveis por enfraquecerem as defesas do organismo e consequentemente não responder adequadamente a infecções virais e bacterianas, como também estão associados complicações micro e macrovasculares que podem afetar a sobrevida geral do paciente 26 . Uma metanálise realizada por Guo et al comprovou que pacientes com DM prévio estão mais susceptíveis a desenvolverem infecções graves e consequentemente evoluírem com piores desfechos 27 .…”

Covid-19 and Thyroid: A Scopus-based Bibliometric Assessment of Research Output

“…16 This was probably related to the lower contribution to morbidity and mortality and ease of management of thyroid disorders as compared to diabetes in patients with Covid-19. [6][7][8][9] In addition, almost 40% of the research was conducted in two high-income countries, i.e., the USA and Italy. Although several low-and middle-income countries such as Brazil, Libya, and African countries have reported a high prevalence of thyroid disorders in the immediate pre-Covid era, only China and India could manage to contribute significantly to thyroid research concerning Covid-19.…”

“…While diabetes remains the most common association, other endocrine dysfunction such as adrenal insufficiency, low T3 and low TSH syndrome, hyperprolactinemia, and hypopituitarism also occur in a significant proportion of patients with moderate or severe Covid-19. [6][7][8] A recent hospital-based study found thyroid dysfunction in almost one-fourth of Covid-19 patients who underwent hormonal profiles. 7 Indeed, virtually all kinds of non-neoplastic thyroid diseases such as Hashimoto's thyroiditis, Graves' disease, subacute thyroiditis, Low T3 and low T4 syndrome, etc., have been reported to complicate Covid-19.…”

Saúde Contemporânea e Evidências Científicas

“…Esta inflamação pode levar à falência de múltiplos órgãos. A interação entre essa comorbidade e a COVID-19 pode agravar o DM preexistente ou predispor o aparecimento desta em indivíduos não diabéticos(BONANSEA et al, 2021).…”