New-Onset Diabetes in Covid-19

Rubino, Francesco; Amiel, Stephanie A.; Zimmet, Paul; Alberti, K. G. M. M.; Bornstein, Stefan R.; Eckel, Robert H.; Mingrone, Geltrude; Boehm, Bernhard O.; Cooper, Mark E.; Chai, Zhonglin; Prato, Stefano Del; Ji, Linong; Hopkins, David; Herman, William H.; Khunti, Kamlesh; Mbanya, Jean Claude; Renard, Éric

doi:10.1056/nejmc2018688

Cited by 673 publications

(711 citation statements)

References 5 publications

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“…On the other hand, the appearance of new onset or worsening of pre-existing diabetes has been identi ed in COVID-19 patients 51 . α-hydroxybutyric acid is an early marker of insulin resistance in the non-diabetic population 52,53 .…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Metabolomic Profile: A Link Between Lung Dysfunction Markers and Altered Amino Acid Metabolism

Páez-Franco¹,

Torres-Ruíz²,

Sosa-Hernández³

et al. 2020

Preprint

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We identified the main changes in serum metabolites associated with severe (n=46) and mild (n=19) COVID-19 patients by gas chromatography coupled to mass spectrometry. The modified metabolic profiles were associated to an altered amino acid catabolism in hypoxic conditions. Noteworthy, three 𝛼-hydroxyl acids of amino acid origin increased with disease severity and correlated with altered oxygen saturation levels and clinical markers of lung damage. We hypothesize that the enzymatic conversion of 𝛼-keto-acids to 𝛼- hydroxyl-acids helps to maintain NAD recycling in patients with altered oxygen levels, highlighting the potential relevance of amino acid supplementation during SARS-CoV-2 infection.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Metabolomic Profile: A Link Between Lung Dysfunction Markers and Altered Amino Acid Metabolism

Páez-Franco¹,

Torres-Ruíz²,

Sosa-Hernández³

et al. 2020

Preprint

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“…These issues are of great importance in interpreting the ndings of epidemiological studies. Furthermore, Bello-Chavolla OY, et al declared early-onset diabetes and obesity as risk factors for mortality in COVID-19 patients in Mexico [31]. Therefore, newly diagnosed diabetes mellitus with uncontrolled hyperglycemia may be linked to increased risk of COVID-19 fatality.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, newly diagnosed diabetes mellitus with uncontrolled hyperglycemia may be linked to increased risk of COVID-19 fatality. On the other hand, since ACE2 receptors are expressed in pancreatic beta cells, it is plausible that SARS-CoV-2 cause alterations in glucose metabolism which result in complication of the pathophysiology of preexisting diabetes or newonset diabetes [31]. Although it has been shown that obesity mediates 49.5% of the COVID-19 lethality which attributed to diabetes in Mexican population [32], we had no data on weight status of patients for adjustment.…”

Section: Discussionmentioning

confidence: 99%

Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease

Rastad

Karim

Ejtahed

et al. 2020

Preprint

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Background: Diabetes mellitus (DM) and cardiovascular disease (CVD) are present in a large number of patients with novel Coronavirus disease 2019 (COVID-19). We aimed to determine the risk and predictors of in-hospital mortality from COVID-19 in patients with DM and CVD.Methods: This retrospective cohort study included hospitalized patients aged ≥ 18 years with confirmed COVID-19 in Alborz province, Iran, from 20 February 2020 to 25 March 2020. Data on demographic, clinical and outcome (in-hospital mortality) data were obtained from electronic medical records. Self-reported comorbidities were classified into the following groups: “DM” (having DM with or without other comorbidities), “only DM” (having DM without other comorbidities), “CVD” (having CVD with or without other comorbidities), “only CVD” (having CVD without other comorbidities), and “having any comorbidity”. Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities.Results: Among 2957 patients with COVID-19, 2656 were discharged as cured, and 301 died. In multivariate model, DM (OR: 1.62 (95%CI: 1.14-2.30)) and only DM (1.69 (1.05-2.74)) increased the risk of death from COVID-19; but, both CVD and only CVD showed non-significant associations (p>0.05). Moreover, “having any comorbidities” increased the risk of in-hospital mortality from COVID-19 (OR: 2.66 (95%CI: 2.09 -3.40)). Significant predictors of mortality from COVID-19 in patients with DM were lymphocyte count, creatinine and C-reactive protein (CRP) level (all P- values < 0.05).Conclusions: Our findings suggest that diabetic patients have an increased risk of in-hospital mortality following COVID-19; also, lymphocyte count, creatinine and CRP concentrations could be considered as significant predictors for the death of COVID-19 in these patients.

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“…In that regard, the detailed examination of patients developing β-cell failure and insulin-dependent diabetes after a COVID-19 infection in the future might yield novel insight into the yet unknown role of ACE2 in β-cell function and also possible virus induced cytolytic processes in type 1 diabetes development. Thus, a global registry has been launched to provide a systematic platform for collecting and analyzing these patients [15] . It will be critical to explore the frequency, severity and duration of these complications and to explore more deeply the mechanisms in primary human tissue.…”

Section: Discussionmentioning

confidence: 99%

Autoantibody-negative insulin-dependent Diabetes after COVID-19

Hollstein

Schulz

Glück

et al. 2020

Preprint

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Abstract Here we report the manifestation of insulin dependent diabetes after a COVID-19 infection in the absence of typical autoantibodies for type 1 diabetes. A 19-year-old Caucasian male subject presented to our emergency department with diabetic ketoacidosis (DKA). C-peptide levels accounted to 0.62µg/L in the presence of blood glucose concentrations of 30.6 mmol/L (552 mg/dL). The patient´s case history revealed a COVID-19 disease 6-8 weeks prior to admission. This is of interest, since COVID-19 internalization into host cells is mediated via Angiotensin-converting enzyme 2 (ACE2) [1], a transmembrane glycoprotein which amongst others is crucial for β-cell homeostasis and function [2,3,4]. Detailed laboratory testing was performed, revealing no serum-antibodies against islet-cells (ICA), glutamic acid decarboxylase (GAD65-AA), tyrosine phosphatase (IA-2-AA), insulin (IAA) and zinc-transport-8 (ZnT8-AA), but against COVID-19. Hence, this is a presentation of an insulin-dependent diabetes mellitus in the absence of markers of autoimmunity, which might suggest direct cytolytic effects of COVID-19 on pancreatic β-cells presumably mediated via ACE2.

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New-Onset Diabetes in Covid-19

Cited by 673 publications

References 5 publications

COVID-19 Metabolomic Profile: A Link Between Lung Dysfunction Markers and Altered Amino Acid Metabolism

COVID-19 Metabolomic Profile: A Link Between Lung Dysfunction Markers and Altered Amino Acid Metabolism

Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease

Autoantibody-negative insulin-dependent Diabetes after COVID-19

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