Abstract
Simple SummaryAmidst the dual pandemics of diabetes and coronavirus disease 2019 (COVID-19), with the constant emergence of novel variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a vicious cycle has been created, i.e., a hyperglycemic state contributes to the severe clinical course of COVID-19, which in turn has deleterious effects on glycometabolism and in some cases causes new-onset diabetes. Here, we present a comprehensive review of the current literature on the clinical and experimental findings associated with the interrelationship between diabetes and COVID-19. To control disease outcomes and glucometabolic complications in COVID-19, this issue is still being investigated.The coronavirus disease 2019 (COVID-19) global pandemic, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains uncontrolled, with the spread of emerging variants. According to accumulating evidence, diabetes is one of the leading risk factors for a severe COVID-19 clinical course, depending on the glycemic state before admission and during COVID-19 hospitalization. Multiple factors are thought to be responsible, including an altered immune response, coexisting comorbidity, and disruption of the renin-angiotensin system through the virus–host interaction. However, the precise underlying mechanisms remain under investigation. Alternatively, the focus is currently on the diabetogenic and ketosis-prone potential of SARS-CoV-2 itself, even for probable triggers of stress and steroid-induced hyperglycemia in COVID-19. In this article, we present a comprehensive review of the recent literature on the clinical and experimental findings associated with diabetes and COVID-19, and we discuss their bidirectional relationship, i.e., the risk for an adverse prognosis and the deleterious effects on glycometabolism. Accurate assessments of the incidence of new-onset diabetes induced by COVID-19 and its pathogenicity are still unknown, especially in the context of the circulation of SARS-CoV-2 variants, such as Omicron (B.1.1.529), which is a major challenge for the future.
Highlights
Among the global outbreaks of the modern age, coronavirus disease 2019 (COVID-19) has become second only to the Spanish flu in terms of the number of deaths due to respiratory virus diseases [1]
We focus on the clinical and experimental findings associated with diabetes and COVID-19 and discuss the bidirectional interrelationships between these diseases
Fadini et al demonstrated that a higher fasting plasma glucose (FPG) level at admission with each 2 mmol/L (36 mg/dL) increase was associated with COVID-19 severity, with a stronger association among patients without diabetes than with diabetes [40]
Summary
Among the global outbreaks of the modern age, coronavirus disease 2019 (COVID-19) has become second only to the Spanish flu in terms of the number of deaths due to respiratory virus diseases [1]. Individuals infected with SARS-CoV-2 present with a broad spectrum of clinical manifestations, from asymptomatic to lethal This suggests that the virus antigenicity and host factors, such as age, sex, underlying health conditions, and genetic characteristics, may affect the natural history of COVID-19. In a meta-analysis reported by Pugliese et al, the prevalence of diabetes among COVID-19 patients was not higher than that of the general population, in China, Europe, and the United States [22]. It is not epidemiologically obvious whether diabetes carries a significant risk of SARS-CoV-2 infection
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