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Endothelial activation and dysfunction in metabolic syndrome, type 2 diabetes and coronavirus disease 2019

Melvin R Hayden1,2,3

  • 1Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Camdenton, Missouri, USA.

The Journal of International Medical Research
|July 30, 2020
PubMed

Insights

Type 2 diabetes mellitus (T2DM) exacerbates COVID-19 severity by damaging blood vessels and endothelial cells. Understanding these links is crucial for managing diabetic patients during the pandemic.

Area of Science:

  • Cardiovascular Science
  • Infectious Diseases
  • Endocrinology

Background:

  • COVID-19, caused by SARS-CoV-2, presents increased risks for older individuals, males, and those with comorbidities like cardiovascular disease, diabetes, and smoking.
  • Type 2 Diabetes Mellitus (T2DM) is an age-related condition characterized by metabolic dysfunction, including insulin resistance, hyperglycemia, and endothelial issues.
  • Endothelial cell activation and dysfunction are increasingly recognized as critical factors in both T2DM and severe COVID-19 outcomes.

Purpose of the Study:

  • To review the intricate relationship between endothelial cell activation and dysfunction in the context of Type 2 Diabetes Mellitus (T2DM) and COVID-19.
  • To elucidate how COVID-19 may exacerbate pre-existing vascular vulnerabilities in patients with T2DM.
  • To highlight the importance of understanding the intersection of T2DM and COVID-19 for global health strategies.

Main Methods:

  • This is a review article, synthesizing existing research on COVID-19 pathophysiology and T2DM.
  • The review focuses on the impact of both conditions on endothelial cells and vascular integrity.
  • Literature analysis was conducted to evaluate the intersection of T2DM-related endothelial dysfunction and COVID-19-induced vascular injury.

Main Results:

  • COVID-19 causes significant injury to the respiratory system's microvasculature, including the alveolar blood-gas barrier.
  • The virus can unmask and worsen pre-existing endothelial damage in T2DM patients, affecting the endothelial glycocalyx and leading to macro/microvascular complications.
  • T2DM shares common pathways with COVID-19 that promote endothelial activation and dysfunction, contributing to severe disease.

Conclusions:

  • T2DM significantly increases morbidity and mortality in COVID-19 patients due to shared pathways of endothelial dysfunction.
  • COVID-19 exacerbates the vascular complications inherent in T2DM, leading to multi-organ damage.
  • Further research is essential to understand and mitigate the heightened risks faced by diabetic individuals infected with SARS-CoV-2.

Keywords:
Coronavirus disease 2019endothelial activationendothelial dysfunctionendothelial glycocalyxmetabolic syndromerepurposingsevere acute respiratory syndrome corona virus-2type 2 diabetes mellitus

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