An update on the interaction between COVID-19, vaccines, and diabetic kidney disease

Abstract

Up to now, coronavirus disease 2019 (COVID-19) is still affecting worldwide due to its highly infectious nature anrapid spread. Diabetic kidney disease (DKD) is an independent risk factor for severe COVID-19 outcomes, and they have a certain correlation in some aspects. Particularly, the activated renin–angiotensin–aldosterone system, chronic inflammation, endothelial dysfunction, and hypercoagulation state play an important role in the underlying mechanism linking COVID-19 to DKD. The dipeptidyl peptidase-4 inhibitor is considered a potential therapy for COVID-19 and has similarly shown organ protection in DKD. In addition, neuropilin-1 as an alternative pathway for angiotensin-converting enzyme 2 also contributes to severe acute respiratory syndrome coronavirus 2 entering the host cells, and its decreased expression can affect podocyte migration and adhesion. Here, we review the pathogenesis and current evidence of the interaction of DKD and COVID-19, as well as focus on elevated blood glucose following vaccination and its possible mechanism. Grasping the pathophysiology of DKD patients with COVID-19 is of great clinical significance for the formulation of therapeutic strategies.

Understanding the effects of Covid-19 on patients with diabetic nephropathy: a systematic review

“…A review study published on 20 October 2022 10 examined the correlation between COVID-19 and DKD and the potential mechanisms for elevated blood glucose levels following vaccination. A study conducted in a German community hospital analyzed a cohort of 75 COVID-19 patients.…”

“…To Summarize, article 10 emphasizes that the connection between COVID-19 and DKD is intricate and bidirectional, with RAAS activation, chronic inflammation, and endothelial dysfunction being the key factors connecting the two conditions. Endothelial dysfunction leads to a procoagulant and anti-fibrinolytic state, whereas SARS-CoV-2 disrupts the glucose-insulin axis, causing oxidative stress and worsening DKD.…”

Unveiling the impact of COVID-19 on diabetics: vaccination status and infection rates in a North Indian state-insights from a primary healthcare centre-based non-communicable disease registry

“…Our study found that 16.6% of the participants tested positive for COVID-19, which is higher when compared to 7.5% in a study conducted by Nachimuthu et al but around equal to 17.1% in the study by Tourkamani et al whereas 11% and 8% prevalence of diabetes in patients with COVID-19 in studies by Singh et al and Yang et al respectively. [7][8][9][10] In India, 70% of the total population is fully vaccinated and almost 16% of the total population has also received the 3 rd precautionary dose. 2 Our study found that 91.3% of subjects received at least one dose, which is far much higher than the 21.5% found in the study by Nachimuthu et al in 2021 and 25.2% in Chinese patients in the study by Duan et al in 2022, but nearly equal to 84.8% found in study by Tourkamani et al Saudi Arabia in 2022.…”