Diabetes Mellitus and COVID-19: Possible Interactions and Mechanisms in Comorbid Patients

Abstract

Beginning in December 2019 and still ongoing, coronavirus disease 2019 (COVID-19) infections have posed a public health challenge worldwide. There have been reports of diabetes mellitus (DM) as one of the most prevalent comorbidities in patients with COVID-19. Although the interactions and possible mechanisms of this association have not been fully established, the existence of DM is believed to aggravate the adverse effects of COVID-19 infection. Hence, the need for this paper. Findings from other studies have shown different possible mechanisms of how COVID-19 and DM aggravate the severity of each other. Among the hypothetical mechanisms reported between COVID-19 and DM in this paper are: COVID-19 causes complications of DM through the following: (1) Destruction of β-cells in the pancreas by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. (2) Cytokine storm generation which mediates tissue inflammation resulting in organ damage and (3) The use of corticosteroid drugs which have been found to be highly diabetogenic. Similarly, DM facilitates internalizing of SARS-CoV-2 symptoms through increasing expression of angiotensin-converting enzyme 2 (ACE2) and the furin protein, viral load, entrance and replication of SARS-CoV-2, glycosylation, and compromising of the immune response that worsens COVID-19. Having a clear understanding of the biochemical mechanisms of interactions between COVID-19 and DM may be useful for future research of agents targeted as therapeutic remedies for managing patients with diabetes infected with COVID-19 and vice versa.

Soetomo COVID-19 Prognostic Score: A Multi-Parametric Model for Early Prediction of Disease Severity of COVID-19 in Tertiery -Resource Hospital

“…Cardiovascular and metabolic disease patients may have a greater risk of clinical deterioration in COVID-19. In an earlier study, the severe COVID-19 group showed a higher incidence of pre-existing hypertension, cardio-cerebrovascular disease, and diabetes compared with the non-severe group of about two-fold, three-fold, and two-fold, respectively 21,22 . The possible underlying mechanism was suggested a being that a SARS-CoV2 attack over the endothelium aggravated chronic systemic endothelial dysfunction in patients with cardiovascular and metabolic diseases 23 .…”