SARS-CoV-2 and diabetes: New challenges for the disease

Abstract

A novel small enveloped RNA virus with the typical characteristic of the family to which it belongs, a crown, hence the name coronavirus, appeared in December 2019 in Wuhan, China, and subdued the world to its influence. The particular severity of the disease and higher mortality rates in patients with associated morbidities, including hypertension, obesity and diabetes, increases the concern over the consequences of this pandemic. In this review, the features of SARS-CoV-2 will be addressed, as well as the reasons why it poses a particular challenge to diabetic patients. We will also highlight the recent treatment strategies being explored to control this pandemic. Emerging evidence demonstrates that the correct management of diabetes in those patients infected with SARS-CoV-2 is of utmost importance for the viral disease progression, therefore, the importance of blood glucose control will also be addressed.

Animal and translational models of SARS-CoV-2 infection and COVID-19

“…104 The link between type 1 and/or 2 diabetes and ACE2 expression is unknown with conflicting reports on the levels of expression in diabetes progression and severity. 105,106 There are numerous mouse models of type 1 and 2 diabetes that are chemically or genetically induced and, for type 2 diabetes, typically incorporate obesity. 107 SARS-CoV and SARS-CoV-2 infection has not yet been explored in these models but these mice will likely be highly susceptible to infection with pulmonary decline and increased mortality as observed in humans.…”

Retinal outcomes of COVID-19: Possible role of CD147 and cytokine storm in infected patients with diabetes mellitus

“…However, on the one hand, hyperglycemia can affect the immune response and make the organism more susceptible to COVID-19; on the other hand, treatment of DM and its complications with some drugs (e.g. ACE1 inhibitors and angiotensin II receptor blockers) may supposedly lead to overexpression of ACE2 in different organs, also making people with DM more susceptible to SARS-CoV-2 infection [15]. Therefore, it would be interesting that future studies also evaluate the impact of different pharmacological treatments on patients with DM infected by SARS-CoV-2, assessing whether some drugs may also be related to an increased risk of retinal injuries.…”

S494 O-glycosylation site on the SARS-COV-2 RBD Affects the Virus Affinity to ACE2 and its Infectivity; A Molecular Dynamics Study

“…Hence, the O-glycosylation could be the overlooked factor for the SARS-COV-2 increased binding affinity to ACE2, explaining the virus's high infectivity in the human host and exposing people with a higher level of blood sugar at higher risk. 23 Our observations may explain the reason for the higher vulnerability of diabetic patients to infection.…”