COVID‑19 and diabetes mellitus: Unraveling the hypotheses that worsen the prognosis (Review)

Albulescu, Radu; Dima, Simona; Florea, I; Lixandru, Daniela; Serban, Andreea M.; Aspritoiu, Veronica Madalina; Tănase, Cristiana; Popescu, Irinel; Ferber, Sarah

doi:10.3892/etm.2020.9324

Cited by 15 publications

(14 citation statements)

References 99 publications

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“…To our knowledge, this is the first meta-analysis to assess the proportion and mortality of SARS-COV-2 infection in the Iranian DM, CKD, hypertension and CVD patients. Our combined data based on ten studies with 11,755 infected cases and 942 deaths showed that the [21,48,49]. It is well known that allcause mortality rate in patients with DM is higher than in patients without DM [50][51][52].…”

Section: Discussionmentioning

confidence: 82%

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Mirjalili

Dastgheib

Shaker

et al. 2021

J Diabetes Metab Disord

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Background Currently, the number of patients with SARS-COV-2 infection has increased rapidly in Iran, but the risk and mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (DM), chronic kidney disease (CKD), hypertension and cardiovascular diseases (CVDs) still not clear. The aim of this meta-analysis was to estimate the proportion and mortality of SARS-COV-2 in these patients. Methods A comprehensive literature search was carried out in PubMed, Web of Sciences, Cochrane Library, EMBASE, CNKI, SciELO, and other databases to identify all relevant studies published up to 10 January, 2020. The proportion and mortality in the patients were assessed by odd ratio (OR) and the corresponding 95 % confidence interval (95 % CI). Results A total of ten case-series including 11,755 cases with SARS-COV-2 infection and 942 deaths were selected. Among them, there were total of 791 DM patients with 186 deaths, 225 CKD patients with 45 deaths, 790 hypertension cases with 86 deaths, and 471 CVDs cases with 60 deaths. Pooled data revealed that the proportion of SARS-COV-2 infection in the patients with hypertension, DM, CVDs and CKD were 21.1 %, 16.3 %, 14.0 % and 5.0 %, respectively. Moreover, the SARS-COV-2 infection were associated with an increased risk of mortality in DM (OR = 0.549, CI 95 % 0.448-0.671, p ≤ 0.001) and CKD (OR = 0.552, 95 % CI 0.367-0.829, p = 0.004) patients, but not hypertension and CVDs. There was no publication bias. Conclusions Our pooled data showed that the proportion of SARS-COV-2 infection was the highest in the Iranian patients with hypertension (21.1 %) followed by DM (16.3 %), CVDs (14.0 %) and CKD (5.0 %). Moreover, DM and CKD in patients with SARS-COV-2 infection were associated with a 0.549 and 0.552-fold increase in mortality, respectively. Clinicians in Iran should be aware of these findings, to identifying patients at higher risk and inform interventions to reduce the risk of death. Moreover, well-designed, large-scale and multicenter studies are needed to improve and validate our findings.

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Section: Discussionmentioning

confidence: 82%

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Mirjalili

Dastgheib

Shaker

et al. 2021

J Diabetes Metab Disord

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“…Furthermore, hyperglycemia and induced oxidative stress and gluco-lipotoxicity contribute to the development of IR and impairment of pancreatic β-cell function ( 15 ). In addition, prolonged hyperglycemia could worsen the course of COVID-19 via glycation of pancreatic ACE2, which facilitates the SARS-CoV-2 binding and entry at the pancreatic β-cell ( 16 ).…”

Section: Covid-19 and Hyperglycemiamentioning

confidence: 99%

COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus

Al-Kuraishy¹,

Al-Gareeb²,

Alblihed

et al. 2021

Front. Cardiovasc. Med.

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Coronavirus disease 2019 (COVID-19), triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), may lead to extrapulmonary manifestations like diabetes mellitus (DM) and hyperglycemia, both predicting a poor prognosis and an increased risk of death. SARS-CoV-2 infects the pancreas through angiotensin-converting enzyme 2 (ACE2), where it is highly expressed compared to other organs, leading to pancreatic damage with subsequent impairment of insulin secretion and development of hyperglycemia even in non-DM patients. Thus, this review aims to provide an overview of the potential link between COVID-19 and hyperglycemia as a risk factor for DM development in relation to DM pharmacotherapy. For that, a systematic search was done in the database of MEDLINE through Scopus, Web of Science, PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang Data. Data obtained underline that SARS-CoV-2 infection in DM patients is more severe and associated with poor clinical outcomes due to preexistence of comorbidities and inflammation disorders. SARS-CoV-2 infection impairs glucose homeostasis and metabolism in DM and non-DM patients due to cytokine storm (CS) development, downregulation of ACE2, and direct injury of pancreatic β-cells. Therefore, the potent anti-inflammatory effect of diabetic pharmacotherapies such as metformin, pioglitazone, sodium-glucose co-transporter-2 inhibitors (SGLT2Is), and dipeptidyl peptidase-4 (DPP4) inhibitors may mitigate COVID-19 severity. In addition, some antidiabetic agents and also insulin may reduce SARS-CoV-2 infectivity and severity through the modulation of the ACE2 receptor expression. The findings presented here illustrate that insulin therapy might seem as more appropriate than other anti-DM pharmacotherapies in the management of COVID-19 patients with DM due to low risk of uncontrolled hyperglycemia and diabetic ketoacidosis (DKA). From these findings, we could not give the final conclusion about the efficacy of diabetic pharmacotherapy in COVID-19; thus, clinical trial and prospective studies are warranted to confirm this finding and concern.

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“…To further explore the functionality of the PLATIPUS application, we demonstrate an example via a case study. There has been significant evaluation of comorbidities such as diabetes on the prognostic response of patients with COVID-19 [ 20 - 23 ]. In this case study, the search of the term “diabetes” in PLATIPUS returns 2769 articles from the originating 159,797, as of May 2021 ( Figure 4 A).…”

Section: Resultsmentioning

confidence: 99%

Online Interactive Platform for COVID-19 Literature Visual Analytics: Platform Development Study

Moran¹,

Hampton²,

Dowson³

et al. 2021

J Med Internet Res

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Background Papers on COVID-19 are being published at a high rate and concern many different topics. Innovative tools are needed to aid researchers to find patterns in this vast amount of literature to identify subsets of interest in an automated fashion. Objective We present a new online software resource with a friendly user interface that allows users to query and interact with visual representations of relationships between publications. Methods We publicly released an application called PLATIPUS (Publication Literature Analysis and Text Interaction Platform for User Studies) that allows researchers to interact with literature supplied by COVIDScholar via a visual analytics platform. This tool contains standard filtering capabilities based on authors, journals, high-level categories, and various research-specific details via natural language processing and dozens of customizable visualizations that dynamically update from a researcher’s query. Results PLATIPUS is available online and currently links to over 100,000 publications and is still growing. This application has the potential to transform how COVID-19 researchers use public literature to enable their research. Conclusions The PLATIPUS application provides the end user with a variety of ways to search, filter, and visualize over 100,00 COVID-19 publications.

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COVID‑19 and diabetes mellitus: Unraveling the hypotheses that worsen the prognosis (Review)

Cited by 15 publications

References 99 publications

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus

Online Interactive Platform for COVID-19 Literature Visual Analytics: Platform Development Study

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