Journal Article

Diabetes and COVID-19: evidence, current status and unanswered research questions

Hussain Akhtar, Gupta, Ritesh, Misra Anoop

2020

Overview

Patients with diabetes who get coronavirus disease 2019 (COVID-19) are at risk of a severe disease course and mortality. Several factors especially the impaired immune response, heightened inflammatory response and hypercoagulable state contribute to the increased disease severity. However, there are many contentious issues about which the evidence is rather limited. There are some theoretical concerns about the effects of different anti-hyperglycaemic drugs. Similarly, despite the recognition of angiotensin converting enzyme 2 (ACE2) as the receptor for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), and the role of ACE2 in lung injury; there are conflicting results with the use of angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in these patients. Management of patients with diabetes in times of restrictions on mobility poses some challenges and novel approaches like telemedicine can be useful. There is a need to further study the natural course of COVID-19 in patients with diabetes and to understand the individual, regional and ethnic variations in disease prevalence and course.

• Publisher: Nature Publishing Group
• Subject: ACE2 / Angiotensin-converting enzyme 2 / Angiotensin-converting enzyme inhibitors / Coronaviridae / Coronaviruses / COVID-19 / Diabetes / Diabetes mellitus / Enzymes / Immune response / Immunosuppressive agents / Inflammation / Inflammatory response / Peptidyl-dipeptidase A / Receptors / Respiratory diseases / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Telemedicine / Viral diseases