COVID-19: Diabetes Perspective-Pathophysiology and Management

Area of Science:

• Endocrinology
• Infectious Diseases
• Public Health

Background:

• Limited evidence exists on COVID-19's impact on diabetes.
• Diabetes is a risk factor for severe COVID-19, increasing mortality and complications like ARDS and multi-organ failure.
• COVID-19 can lead to new-onset hyperglycemia and diabetes, indicating a bidirectional relationship.

Purpose of the Study:

• To review the impact of COVID-19 on diabetes.
• To explore potential mechanisms linking COVID-19 and diabetes.
• To provide clinical management recommendations for COVID-19 patients with diabetes.

Main Methods:

• Systematic review of emerging evidence.
• Analysis of proposed hypotheses for increased COVID-19 incidence and severity in diabetics.
• Review of clinical management strategies.

Main Results:

• Diabetic patients face increased COVID-19 severity and complications due to factors like increased viral entry and decreased immunity.
• 20-50% of COVID-19 patients develop new-onset hyperglycemia or diabetes.
• Hyperglycemia in COVID-19 patients is linked to SARS-CoV-2 infection, glucocorticoids, catecholamines, and pro-inflammatory cytokines.

Conclusions:

• Diabetes is a significant complication in COVID-19 patients.
• Understanding the mechanisms linking COVID-19 and diabetes is crucial.
• Clinical management recommendations are needed for effective disease handling.