Diabetes mellitus and COVID-19: review of a lethal interaction from the cellular and molecular level to the bedside

ABSTRACT

Introduction

While the main mode of transmission of coronavirus disease 2019 (COVID-19) is close contact with other individuals, the presence of chronic underlying diseases such as Diabetes Mellitus (DM) increases the chance of hospitalization and mortality rate due to infection.

Areas covered

To investigate the effects of COVID-19 infection in DM patients, we reviewed literature from Google Scholar search engine and PubMed database from ‘2013 to 2020’ using the terms “COVID-19; SARS-CoV-2; Diabetes mellitus; obesity; Angiotensin-converting enzyme 2; ACE2; Insulin and Metformin. Evidence suggests that COVID-19 exacerbates the course of diabetes. Presence of pro-inflammatory conditions, increased expression of receptors, and more difficult control of glucose levels in diabetics COVID-19 patients are some of the problems that diabetic patients may face. Also, psychological problems caused by the COVID-19 epidemic in diabetic patients is one of the most important problems in these patients, which is less covered.

Expert opinion

DM is a strong and independent risk factor with a poor prognosis, which increases the risk of COVID-19 infection, the need for emergency services, the rate of hospitalization in the intensive care unit and also increases the mortality rate of COVID-19 patients.

KEYWORDS:

• COVID-19
• SARS-CoV-2
• diabetes mellitus
• obesity
• angiotensin-converting enzyme 2
• ACE2
• Insulin and Metformin

Declaration of interest

The author(s) have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Author contributions

S.M.S.P. conceived and revised the manuscript. T.A.K.; F.Z.; A.F.H.; P.P. and S.M.S.P. wrote the manuscript. F.Z. prepared tables and figures. Also, S.P.P. helped us in revising and correcting the manuscript.

Additional information

Funding

The authors have no funding to report.