Diabetes mellitus and COVID-19. How are they connected? Current strategy of fight
https://doi.org/10.18705/1607-419X-2020-26-3-304-311
Abstract
Infectious epidemic of COVID-19 caused by the new coronavirus is characterized by severe course in patients with diabetes mellitus, which presents another noninfectious pandemic accelerating for last decades. Today, according to the International Diabetic Federation data, there are 463 million patients with diabetes mellitus in the world. The burden of the COVID-19 epidemic is largely explained by a frequent combination of these two pathologies. From the previous flu epidemics and already available data of the current epidemic, diabetes mellitus and obesity are considered to be the predictors of more severe course of COVID-19 and mortality. On the other hand, SARS-CoV-2 can aggravate diabetes mellitus, via direct damage of pancreatic beta cells and the liver injury, resulting in higher insulin resistance. We discuss the mechanisms underlying the relation between coronavirus infection and diabetes mellitus and consequences of their mutual influence. Also the article reviews potential strategies of personalized therapy in COVID-19. Timely control and maintenance of individualized target glycemic level is the cornerstone of successful prevention of COVID-19 complications. Disease severity defines strategy of treatment and the choice of antihyperglycemic therapy.
About the Authors
A. Yu. Babenko
Almazov National Medical Research Centre
Russian Federation
Alina Yu. Babenko, MD, PhD, DSc, Chief Researcher, Head, Research Laboratory of Diabetology, Institute of Endocrinology
Russian Federation
Alina Yu. Babenko, MD, PhD, DSc, Chief Researcher, Head, Research Laboratory of Diabetology, Institute of Endocrinology
2 Akkuratov street, St Petersburg, 197341
M. Yu. Laevskaya
Almazov National Medical Research Centre
Russian Federation
Russian Federation
Maria Yu. Laevskaya, MD, PhD, Senior Researcher, Research Laboratory of Diabetology, Institute of Endocrinology
St Petersburg
References
1. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q. Prevalence of comorbidities and its effects in patients infected with SARSCoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91–95. doi:10.1016/j.ijid.2020.03
2. Yang L, Chan KP, Lee RS, Chan WM, Lai HK, Thach TQ et al. Obesity and influenza associated mortality: evidence from an elderly cohort in Hong Kong. Prev Med. 2013;56(2):118–123.
3. Morgan OW, Bramley A, Fowlkes A, Freedman DS, Taylor TH, Gargiullo P et al. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A (N 1) disease. PLoS One. 2010;15;5(3):e9694. doi:10.1371/journal.pone.0009694
4. Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell LF, Chernyak Y et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. Br Med J. 2020;369: m1966. doi.org/10.1136/bmj.m1966
5. Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring). 2020. [Ahead of print, published online 9 April 2020]. doi:10.1002/oby.22831
6. Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clin Infect Dis. 2020. [Ahead of print, published online 9 April 2020]. doi:10.1093/cid/ciaa415
7. Xue T, Li Q, Zhang Q, Lin W, Wen J, Li L et al. Blood glucose levels in elderly subjects with type 2 diabetes during COVID-19 outbreak: a retrospective study in a single center. medRxiv. 2020. [Рublished online 2 April 2020]. doi:10.1101/2020.03.31.20048579
8. Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE 2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med. 2020;46(4):586–590. doi:10.1007/s00134020-05985-9
9. Turner AJ, Hooper NM. The angiotensin-converting enzyme gene family: genomics and pharmacology. Trends Pharmacol Sci. 2002;23(4):177–183.
10. Batlle D, Soler MJ, And Ye M. ACE 2 and Diabetes: ACE of ACEs? Diabetes. 2010;59(12):2994–2996. doi:10.2337/db10-1205
11. Tikellis C, Wookey PJ, Candido R, Andrikopoulos S, Thomas MC, Cooper ME. Improved islet morphology after blockade of the renin-angiotensin system in the ZDF rat. Diabetes. 2004;53(4):989–997.
12. Ye M, Wysocki J, William J, Soler MJ, Cokic I, Batlle D. Glomerular localization and expression of angiotensin-converting enzyme 2 and angiotensin-converting enzyme: implications for albuminuria in diabetes. J Am Soc Nephrol. 2006;17(11):30673075.
13. Reich HN, Oudit GY, Penninger JM, Scholey JW, Herzenberg AM. Decreased glomerular and tubular expression of ACE 2 in patients with type 2 diabetes and kidney disease. Kidney Int. 2008;74(12):1610–1616.
14. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S et al. SARS-CoV-2 cell entry depends on ACE 2 and TMPRSS 2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271–280. doi:10.1016/j.cell.2020.02.052
15. Zhao Y, Zhao Z, Wang Y, Zhou Y, Ma Y, Zuo W. Singlecell RNA expression profiling of ACE 2, the putative receptor of Wuhan COVID-19. 2020. [Ahead of print, published online 9 April 2020]. doi.org/10.1101/2020.01.26.919985
16. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J Virology. 2020;94(7):127–120. doi:10.1128/JVI.00127-20
17. Bornstein SR, Dalan R, Hopkins D, Mingrone G, Boehm BO. Endocrine and metabolic link to coronavirus infection. Nat Rev Endocrinol. 2020;16(6):297–298. doi.org/10.1038/s41574-0200353-9
18. Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with Covid-19. N Engl J Med. 2020;382(17):1653–1659. doi.org/10.1056/NEJMsr2005760
19. Yang JK, Lin SS, Ji XJ, Guo LM. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol. 2010;47(3):193–199. doi.org/10.1007/s00592-0090109-4
20. Carlsson PO, Berne C, Jansson L. Angiotensin II and the endocrine pancreas: effects on islet blood flow and insulin secretion in rats. Diabetologia. 1998;41(2):127–133.
21. Roca-Ho H, Riera M, Palau V, Pascual J, Soler MJ. Characterization of ACE and ACE 2 expression within different organs of the NOD mouse. Int J Mol Sci. 2017;18(3):563. doi:10.3390/ijms18030563
22. Richard C, Wadowski M, Goruk S, Cameron L, Sharma AM, Field CJ. Individuals with obesity and type 2 diabetes have additional immune dysfunction compared with obese individuals who are metabolically healthy. BMJ Open Diabetes Res Care. 2017;5(1): e000379. doi:10.1136/bmjdrc-2016-000379
23. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. 2011;11(2):85–97.
24. Green WD, Beck MA. Obesity impairs the adaptive immune response to influenza virus. Ann Am Thorac Soc. 2017;14(Suppl. 5):S 406–S 409.
25. Ussher JR, Drucker DJ. Endocrine Reviews. 2012; 33(2):187–215. doi:10.1210/er.2011-1052
26. Sell H, Blüher M, Klöting N, Schlich R, Willems M, Ruppe F et al. Adipose dipeptidyl peptidase-4 and obesity: correlation with insulin resistance and depot-specific release from adipose tissue in vivo and in vitro. Diabetes Care. 2013;36(12):4083–4090. doi:10.2337/dc13-0496
27. Iacobellis G. COVID-19 and diabetes: Can DPP4 inhibition play a role? Diabetes Res Clin Pract. 2020;26(162):108–125. doi:10.1016/j.diabres.2020.108125
28. Raj VS, Mou H, Smits SL, Dekkers DH, Müller MA, Dijkman R et al. Dipeptidyl peptidase 4 is a functional receptor for the emerging human coronavirus-EMC. Nature. 2013;495(7440):251–254. doi:10.1038/nature12005
29. Canton J, Fehr АR, Fernandez-Delgado R, GutierrezAlvarez FJ, Sanchez-Aparicio MT, García-Sastre A et al. MERSCoV 4b protein interferes with the NF-κB-dependent innate immune response during infection. PLoS Pathog. 2018;14(1):e1006838. doi:10.1371/journal.ppat.1006838
30. Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol. 2020;5(4):562–569. doi:10.1038/s41564-020-0688-y
31. [Electronic resource]. URL: https://www.clinicaltrials.gov/ct2/show/NCT04341935
32. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C at al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020: e3319. doi:10.1002/dmrr.3319
33. Guo J, Hang Z, Lin L, Lv J. Coronavirus disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome Coronavirus 2 infection. J Am Heart Assoc. 2020;9(7):e016219. doi:10.1161/JAHA.120.016219
34. Ma W-X, Ran X-W. The management of blood glucose should be emphasized in the treatment of COVID-19. Sichuan Da Xue Xue Bao Yi Xue Ban. 2020;51(2):146–150. doi:10.12182/20200360606
35. Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL at al. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12(4):988. doi:10.3390/nu12040988
36. Barnett JB, Hamer DH, Meydani SN. Low zinc status: a new risk factor for pneumonia in the elderly? Nutr Rev. 2010;68(1):30–37. doi.org/10.1111/j.1753-4887.2009.00253
37. Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr. 2020;14(3):211–212. doi:10.1016/j.dsx.2020.03.002
38. Ma WX, Ran XW. The Management of Blood Glucose Should be Emphasized in the Treatment of COVID - 19. Sichuan Da Xue Xue Bao Yi Xue Ban. 2020;51(2):146–150. doi:10.12182/20200360606
39. Amott C, Li Q, Kang A, Neuen BL, Bompoint S, Lam CSP et al. SGLT2i for the prevention of cardiovascular events in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(3): e014198.
40. Strugaru AM, Botnariu G, Agoroaei L, Grigoriu IC, Butnaru E. Metformin induced lactic acidosis-particularities and course. Rev Med Chir Soc Med Nat Iasi. 2013;117(4):1035–1042.
41. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med. 2020;8(4): e21. doi:10.1016/S22132600(20)30116-8
42. de Simone G. Position statement of the ESC Council on hypertension on ACE-inhibitors and angiotensin receptor blockers. [Electronic resource]. URL: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-theesc-council-on-hypertension-on-ace-inhibitors-and-angDate: 2020 Date accessed: April 15, 2020.
43. Yang W, Cai X, Han X, Ji L. DPP-4 inhibitors and risk of infections: a meta-analysis of randomized controlled trials. Diabetes Metab Res Rev. 2016;32(4):391–404. doi:10.1002/dmrr.2723
44. Pasquel FJ, Fayfman M, Umpierrez GE. Debate on insulin vs non-insulin use in the hospital setting-is it time to revise the guidelines for the management of inpatient diabetes? Curr Diab Rep. 2019;19(9):65. doi:10.1007/s11892-019-1184-8
45. Botta L, Rivara M, Zuliani V, Radi M. Drug repurposing approaches to fight Dengue virus infection and related diseases. Front Biosci (Landmark Ed). 2018;23:997–1019.
46. Grineva EN, Halimov YuS, Babenko AYu, Karonova TL, Tsoi UA, Popova PV et al. Recommendations for the management of patients with COVID-19 and endocrine diseases during a pandemic. [Electronic resource]. URL: http://www.almazovcentre.ru/?p=62944. In Russian.
47. Algorithms for specialized medical care for patients with diabetes mellitus. Edited by II Dedova, MV Shestakova, AYu Mayorova. 9th edition (add.). Diabetes. 2019;22(S 1). doi:10.14341/DM221S1. In Russian.
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For citations:
Babenko A.Yu., Laevskaya M.Yu. Diabetes mellitus and COVID-19. How are they connected? Current strategy of fight. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2020;26(3):304-311. https://doi.org/10.18705/1607-419X-2020-26-3-304-311
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