Association Between COVID-19 And Diabetes: A Review

Abstract

A viral disease due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus was identified in Wuhan, China in December, 2019 show flu-like symptoms with a dry cough, sore throat, high fever, and breathing problems was named as COVID-19. The virus enters through mucous membranes of the upper respiratory tract; later affecting lungs is highly transmissible from person to person through respiratory secretions. Corona viruses belong to the Coronaviridae family and appear just like spiked rings when observed through an electron microscope. The surface looks with various spikes, which are helpful to attack and bind living cells. These are the viruses causing the simple common cold disease to severe illnesses like Middle East Respiratory Syndrome (MERSCoV), Severe Acute Respiratory Syndrome (SARS-CoV). The source of these viruses is some animals including bats. About 2.2 million people have been infected with more than 0.15 million deaths globally. Among those with severe COVID-19 and those who died, there is a high prevalence of concomitant conditions including diabetes, cardiovascular disease, hypertension, obesity, and chronic obstructive pulmonary disease. Diabetes is the chronic diseases with the high prevalence globally make it a frequent comorbidity in patients with coronavirus-associated disease 2019. Diabetes with well-controlled blood glucose levels have an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) varies by region, age and ethnicity. The role of acute glycemic control after COVID- 19 manifestation on clinical outcomes has not been studied yet; however, in influenza in vitro and animal data suggest that, among other negative effects, hyperglycemia facilitates local viral replication in the lungs and impairs anti-viral immune response. Hence acute glycemic management could play an important role in limiting viral replication and disease duration in patients with diabetes. Diabetes patients presented with higher immune dysfunction in individuals including hyperglycemia, inhibition of neutrophil chemotaxis, altered cytokine production, phagocytic cell dysfunction, impaired T cell-mediated immune responses, and ineffective microbial clearance. Alongside, individuals with diabetes have also been shown to have elevated levels of the proinflammatory cytokine, especially IL-1, IL-6, and tumor necrosis factor-α (TNF-α), and different markers such as Creactive protein, D-dimer, and fibrinogen, those may further prolong the cytokine storms and lead to severe illness in diabetic individuals with COVID-19 infection; the role of the markers in COVID-19 is to induce DM. The available evidence implicates diabetes as important risk factors impacting the clinical severity of coronavirus infections, including SARS-CoV-2.