COVID-19: Diabetes Perspective-Pathophysiology and Management

• Published in: Pathogens (Basel) Vol. 12; no. 2; p. 184
• Main Authors: Dallavalasa, Siva, Tulimilli, SubbaRao V, Prakash, Janhavi, Ramachandra, Ramya, Madhunapantula, SubbaRao V, Veeranna, Ravindra P
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25-01-2023; MDPI
• Subjects: ARDS; Catecholamines; Complications and side effects; Coronaviruses; COVID-19; cytokines; Diabetes; Diabetes mellitus; Disabilities; Glucocorticoids; Hyperglycemia; Illnesses; Inflammation; Insulin resistance; Middle East respiratory syndrome; Mortality; Pandemics; Patients; Respiratory distress syndrome; Review; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Viral diseases; Viral infections; India; COVID-19; SARS-CoV-2; cytokines; glucocorticoids; diabetes; ARDS
• ISSN: 2076-0817; 2076-0817
• DOI: 10.3390/pathogens12020184

Recent evidence relating to the impact of COVID-19 on people with diabetes is limited but continues to emerge. COVID-19 pneumonia is a newly identified illness spreading rapidly throughout the world and causes many disabilities and fatal deaths. Over the ensuing 2 years, the indirect effects of the pandemic on healthcare delivery have become prominent, along with the lingering effects of the virus on those directly infected. Diabetes is a commonly identified risk factor that contributes not only to the severity and mortality of COVID-19 patients, but also to the associated complications, including acute respiratory distress syndrome (ARDS) and multi-organ failure. Diabetic patients are highly affected due to increased viral entry into the cells and decreased immunity. Several hypotheses to explain the increased incidence and severity of COVID-19 infection in people with diabetes have been proposed and explained in detail recently. On the other hand, 20-50% of COVID-19 patients reported new-onset hyperglycemia without diabetes and new-onset diabetes, suggesting the two-way interactions between COVID-19 and diabetes. A systematic review is required to confirm diabetes as a complication in those patients diagnosed with COVID-19. Diabetes and diabetes-related complications in COVID-19 patients are primarily due to the acute illness caused during the SARS-CoV-2 infection followed by the release of glucocorticoids, catecholamines, and pro-inflammatory cytokines, which have been shown to drive hyperglycemia positively. This review provides brief insights into the potential mechanisms linking COVID-19 and diabetes, and presents clinical management recommendations for better handling of the disease.