COVID-19 and diabetes mellitus: how one pandemic worsens the other.
William S AzarRachel NjeimAngie H FaresNadim S AzarSami T AzarMazen El SayedAssaad A EidPublished in: Reviews in endocrine & metabolic disorders (2020)
In light of the most challenging public health crisis of modern history, COVID-19 mortality continues to rise at an alarming rate. Patients with co-morbidities such as hypertension, cardiovascular disease, and diabetes mellitus (DM) seem to be more prone to severe symptoms and appear to have a higher mortality rate. In this review, we elucidate suggested mechanisms underlying the increased susceptibility of patients with diabetes to infection with SARS-CoV-2 with a more severe COVID-19 disease. The worsened prognosis of COVID-19 patients with DM can be attributed to a facilitated viral uptake assisted by the host's receptor angiotensin-converting enzyme 2 (ACE2). It can also be associated with a higher basal level of pro-inflammatory cytokines present in patients with diabetes, which enables a hyperinflammatory "cytokine storm" in response to the virus. This review also suggests a link between elevated levels of IL-6 and AMPK/mTOR signaling pathway and their role in exacerbating diabetes-induced complications and insulin resistance. If further studied, these findings could help identify novel therapeutic intervention strategies for patients with diabetes comorbid with COVID-19.
Keyphrases
- sars cov
- coronavirus disease
- public health
- cardiovascular disease
- respiratory syndrome coronavirus
- angiotensin converting enzyme
- insulin resistance
- glycemic control
- type diabetes
- angiotensin ii
- randomized controlled trial
- risk factors
- cardiovascular events
- blood pressure
- adipose tissue
- depressive symptoms
- drug induced
- high glucose
- epithelial mesenchymal transition
- weight loss
- coronary artery disease
- endothelial cells
- protein kinase