Article ; Online: Factors leading to high morbidity and mortality of COVID-19 in patients with type 2 diabetes.
2020 Volume 12, Issue 12, Page(s) 895–908
Abstract: ... and hyperglycemia are among the major comorbidities in patients with COVID-19 leading to poor outcomes ... Reports show that patients with diabetes and COVID-19 are at an increased risk for developing severe ... potential mechanistic links that could explain the observed higher morbidity and mortality in this patient ...
| Abstract | Coronavirus disease 2019 (COVID-19) is a recent pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus. Diabetes (mostly type 2 diabetes mellitus, T2DM) and hyperglycemia are among the major comorbidities in patients with COVID-19 leading to poor outcomes. Reports show that patients with diabetes and COVID-19 are at an increased risk for developing severe complications including acute respiratory distress syndrome, multi-organ failure, and death. Here we explore potential mechanistic links that could explain the observed higher morbidity and mortality in this patient population. Patients with T2DM have an underlying increased level of inflammation associated with obesity and insulin resistance in addition to other comorbidities including hypertension, obesity, cardiovascular disease, dyslipidemia, and being older. We review evidence that T2DM with hyperglycemia are among factors that lead to elevated expression of angiotensin-converting enzyme 2 (ACE2) in lungs and other tissues; ACE2 is the cellular "receptor" and port of viral entry. The preexisting chronic inflammation with augmented inflammatory response to the infection and the increasing viral load leads to extreme systemic immune response ("cytokine storm") that is strongly associated with increased severity of COVID-19. Based on the available evidence, it is recommended by a panel of experts that safe but stringent control of blood glucose, blood pressure, and lipids be carried out in patients with T2DM, measures that could potentially serve to decrease the severity of COVID-19 should these patients contract the viral infection. Once the infection occurs, then attention should be directed to proper glycemic control with use of insulin and frequent monitoring of blood glucose levels. |
|---|---|
| MeSH term(s) | COVID-19/complications ; COVID-19/mortality ; COVID-19/virology ; China/epidemiology ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/mortality ; Diabetes Mellitus, Type 2/virology ; Humans ; Inflammation/physiopathology ; Insulin Resistance ; Morbidity ; Obesity/physiopathology ; Prognosis ; SARS-CoV-2/isolation & purification ; Survival Rate |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-09-02 |
| Publishing country | Australia |
| Document type | Journal Article ; Review |
| ZDB-ID | 2503337-2 |
| ISSN | 1753-0407 ; 1753-0393 |
| ISSN (online) | 1753-0407 |
| ISSN | 1753-0393 |
| DOI | 10.1111/1753-0407.13085 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.A 6791: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.