Impact of diabetes mellitus on clinical outcomes in patients affected by Covid-19

Cardiovasc Diabetol. 2020 Jun 11;19(1):76. doi: 10.1186/s12933-020-01047-y.

Abstract

A possible association could exist between type 2 diabetes mellitus (T2DM) and Coronavirus-19 (Covid-19) infection. Indeed, patients with T2DM show high prevalence, severity of disease and mortality during Covid-19 infection. However, the rates of severe disease are significantly higher in patients with diabetes compared with non-diabetes (34.6% vs. 14.2%; p < 0.001). Similarly, T2DM patients have higher rates of need for Intensive Care Unit (ICU, 37.0% vs. 26.7%; p = 0.028). Thus, about the pneumonia of Covid-19, we might speculate that the complicated alveolar-capillary network of lungs could be targeted by T2DM micro-vascular damage. Therefore, T2DM patients frequently report respiratory symptoms and are at increased risk of several pulmonary diseases. In addition, pro-inflammatory pathways as that involving interleukin 6 (IL-6), could be a severity predictor of lung diseases. Therefore, it looks intuitive to speculate that this condition could explain the growing trend of cases, hospitalization and mortality for patients with T2DM during Covid-19 infection. To date, an ongoing experimental therapy with monoclonal antibody against the IL-6 receptor in Italy seems to have beneficial effects on severe lung disease and prognosis in patients with Covid-19 infection. Therefore, should patients with T2DM be treated with more attention to glycemic control and monoclonal antibody against the IL-6 receptor during the Covid-19 infection?

Keywords: Covid-19; Micro-vascular disease; Several disease; Type 2 diabetes mellitus.

Publication types

  • Editorial

MeSH terms

  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Betacoronavirus / metabolism*
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism*
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology
  • Glycemic Index / drug effects
  • Glycemic Index / physiology
  • Humans
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology
  • Receptors, Interleukin-6 / antagonists & inhibitors
  • Receptors, Interleukin-6 / blood
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Blood Glucose
  • IL6R protein, human
  • Receptors, Interleukin-6