Effect of Hyperglycemia on COVID-19 Outcomes: Vaccination Efficacy, Disease Severity, and Molecular Mechanisms.
Celestino SarduRaffaele MarfellaFrancesco PrattichizzoRosalba La GrottaGiuseppe PaolissoAntonio CerielloPublished in: Journal of clinical medicine (2022)
Acute hyperglycemia at hospital admission represents a risk factor for poor COVID-19 prognosis in patients with and without diabetes. Acute and chronic glycemic control are both emerging as major determinants of vaccination efficacy, disease severity and mortality rate in COVID-19 patients. Mechanistically, it has been proposed that hyperglycemia might be a disease-modifier for COVID-19 through multiple mechanisms: (a) induction of glycation and oligomerization of ACE2, the main receptor of SARS-CoV-2; (b) increased expression of the serine protease TMPRSS2, responsible for S protein priming; (c) impairment of the function of innate and adaptive immunity despite the induction of higher pro-inflammatory responses, both local and systemic. Consistently, managing acute hyperglycemia through insulin infusion has been suggested to improve clinical outcomes, while implementing chronic glycemic control positively affects immune response following vaccination. Although more research is warranted to better disentangle the relationship between hyperglycemia and COVID-19, it might be worth considering glycemic control as a potential route to optimize disease prevention and management.
Keyphrases
- glycemic control
- sars cov
- type diabetes
- coronavirus disease
- blood glucose
- immune response
- liver failure
- respiratory syndrome coronavirus
- drug induced
- weight loss
- respiratory failure
- insulin resistance
- diabetic rats
- aortic dissection
- healthcare
- low dose
- binding protein
- poor prognosis
- cardiovascular disease
- cardiovascular events
- protein protein
- adipose tissue
- dendritic cells
- metabolic syndrome
- small molecule
- intensive care unit
- angiotensin ii
- coronary artery disease
- acute respiratory distress syndrome
- acute care