AIMS Public Health . The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review

[tetano]

AIMS Public Health


. 2021 Oct 26;8(4):720-742.
doi: 10.3934/publichealth.2021057. eCollection 2021.
The underlying mechanisms for severe COVID-19 progression in people with diabetes mellitus: a critical review


María D Figueroa-Pizano[SUP] 1 [/SUP], Alma C Campa-Mada[SUP] 1 [/SUP], Elizabeth Carvajal-Millan[SUP] 1 [/SUP], Karla G Martinez-Robinson[SUP] 1 [/SUP], Agustin Rascon Chu[SUP] 1 [/SUP]



Affiliations

• PMID: 34786431
• PMCID: PMC8568590
• DOI: 10.3934/publichealth.2021057

Abstract

Diabetes mellitus (DM) has a high incidence of comorbidities among patients with severe coronavirus disease 2019 (COVID-19). The elevated prevalence of DM in the world population makes it a significant risk factor because diabetic individuals appear to be prone to clinical complications and have increased mortality rates. Here, we review the possible underlying mechanisms involved in DM that led to worse outcomes in COVID-19. The impacts of hyperglycemia side effects, secondary comorbidities, weakened innate and adaptive immunity, chronic inflammation, and poor nutritional status, commonly present in DM, are discussed. The role of the SARS-CoV-2 receptor and its polymorphic variations on higher binding affinity to facilitate viral uptake in people with DM were also considered. Clinical differences between individuals with type 1 DM and type 2 DM affected by COVID-19 and the potential diabetogenic effect of SARS-CoV-2 infection were addressed.

Keywords: ACE2 polymorphisms; COVID-19; SARS-CoV-2 receptor; chronic inflammation; diabetes mellitus; diabetogenic effect; impaired immune system.

 

[kiwibird]

Comorbidities associated with DM, low-grade inflammatory conditions, deteriorated immune response, and deficient nutritional status are the main factors that expose diabetic individuals to becoming seriously ill during infections.

Sutter et al. [35] concluded that DM alone was not significantly associated with severe consequences in patients with COVID-19 in a French cohort

Their results suggested that severe outcomes (admission to the ICU/in-hospital death) in diabetic patients with COVID-19 was mainly driven by comorbidities accompanying DM rather than DM itself.

Mixed messages here - and no discussion of the fact that Metformin, which reduces B12 - is routinely prescribed to reduce blood pressure. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7659645/

Also haven't even started to think about Covid and newly diagnosed Diabetes - cause or effect? Interesting article Tetano. Thank you. Raises a lot of questions.