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A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
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Diabetes Mellitus, a Leading Comorbidity in COVID-19: an Insight on Pathophysiology, Molecular Interactions, and

Amrita Panja1,2, Sounik Manna1, Moumita Chatterjee3

  • 1Biochemistry, Molecular Endocrinology, and Reproductive Physiology Laboratory, Department of Human Physiology, Vidyasagar University, Midnapore, West Bengal, 721102, India.

Current Microbiology
|July 16, 2025
PubMed

Insights

Diabetic patients face higher COVID-19 mortality due to hyperglycemia, endothelial dysfunction, and altered ACE2 expression. Understanding these factors is crucial for developing effective COVID-19 treatments for diabetes mellitus (DM) patients.

Area of Science:

  • Internal Medicine
  • Endocrinology
  • Infectious Diseases

Background:

  • COVID-19 pandemic poses significant risks, especially for individuals with diabetes mellitus (DM).
  • Diabetic patients exhibit higher mortality rates from COVID-19, necessitating a deeper understanding of contributing factors.
  • Current treatments for COVID-19 lack specificity, highlighting the need for targeted strategies for high-risk populations.

Purpose of the Study:

  • To systematically review biological and clinical risk factors exacerbating COVID-19 severity in diabetic patients.
  • To explore the role of immune and inflammatory pathways in COVID-19 pathogenesis among diabetic individuals.
  • To elucidate pathophysiological mechanisms of viral entry and propagation in the context of diabetes.

Main Methods:

  • Systematic literature review.
  • Analysis of biological mechanisms including chronic hyperglycemia, endothelial dysfunction, and ACE2 expression.
  • Examination of immune and inflammatory responses in COVID-19 patients with and without diabetes.

Main Results:

  • Chronic hyperglycemia, endothelial dysfunction, and dysregulated ACE2 expression are identified as key risk factors in diabetic COVID-19 patients.
  • Distinct immune and inflammatory profiles contribute to differential clinical manifestations of COVID-19 in diabetic versus non-diabetic individuals.
  • Pathophysiological mechanisms facilitating viral entry and spread are more pronounced in diabetic patients.

Conclusions:

  • Understanding the interplay of diabetes and COVID-19 pathogenesis is critical for patient management.
  • Insulin is the current standard for acute hyperglycemia in COVID-19; SGLT2 inhibitors are generally avoided.
  • Further research is essential to develop optimized, evidence-based treatment strategies for diabetic patients with COVID-19.

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