COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course

Landstra, Cyril P; Koning, Eelco J.P. de

doi:10.3389/fendo.2021.649525

Cited by 160 publications

(178 citation statements)

References 162 publications

(237 reference statements)

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“…The presence of typical complications of DM (cardiovascular disease, heart failure and chronic kidney disease) further increases COVID-19 mortality, because the individuals affected may be subject to worse COVID-19 complications including vasculopathy, coagulopathy, and increased psychological stress [104][105][106].…”

Section: Covid-19 Stress and Diabetes: A Bidirectional Relationshipmentioning

confidence: 99%

“…It is worthy of mention that the COVID-19 related lockdown induced a further worsening of the pathology in patients with OB and DM. This stressful period decreased quality of life, with alterations in behavioral and eating patterns, changes in daily life, reduced physical exercise, as well as increased feelings of stress and anxiety, all influencing diabetes self-management, body weight and glycemic control [87][88][89][90][91]105,106].…”

Section: Covid-19 Stress and Diabetes: A Bidirectional Relationshipmentioning

confidence: 99%

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The Stress Axis in Obesity and Diabetes Mellitus: An Update

et al. 2021

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The hypothalamic–pituitary–adrenal axis is a tightly regulated system that represents one of the body’s mechanisms for responding to acute and chronic stress. Prolonged stress and/or inadequate regulation of the stress system can lead to a condition of chronic hypercortisolism or, in some cases, a blunted cortisol response to stress, contributing to insulin resistance, increased adiposity and type 2 diabetes mellitus. Moreover, acute and chronic stress can exacerbate or worsen metabolic conditions by supporting an inflammatory state and a tight relationship between stress, inflammation and adipose tissue has been reported and has been a growing subject of interest in recent years. We reviewed and summarized the evidence supporting hypothalamic–pituitary–adrenal axis dysregulation as an important biological link between stress, obesity, inflammation and type 2 diabetes mellitus. Furthermore, we emphasized the possible role of infectious-related stress such as SarsCov2 infection in adrenal axis dysregulation, insulin resistance and diabetes in a bidirectional link. Understanding and better defining the links between stress and obesity or diabetes could contribute to further definition of the pathogenesis and the management of stress-related complications, in which the HPA axis dysregulation has a primary role.

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Section: Covid-19 Stress and Diabetes: A Bidirectional Relationshipmentioning

confidence: 99%

Section: Covid-19 Stress and Diabetes: A Bidirectional Relationshipmentioning

confidence: 99%

The Stress Axis in Obesity and Diabetes Mellitus: An Update

et al. 2021

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“…Obesity-related diseases and health conditions represent risk factors toward increasing the vulnerability to COVID-19. Diabetes, one of the most known diseases associated with obesity [ 53 , 54 ], represents a risk factor for severe COVID-19 [ 55 , 56 , 57 ]. Cardiovascular diseases, which have their risks increased in obese patients [ 25 , 58 , 59 ], also represent risk factors for COVID-19 [ 60 ].…”

Section: Obesity and The Ongoing Coronavirus Disease 2019 Crisismentioning

confidence: 99%

“…Other obesity-related health problems, such as hypertension and kidney and liver diseases [ 57 ], do represent risk factor for the severe forms of COVID-19. In addition, studies have also explored the fact that COVID-19 could also worsen or lead to other health problems, including diabetes [ 56 , 61 ], and possibly lead to a post-COVID-19 multi-level health crisis [ 62 ]. That would lead to a vicious cycle involving obesity, diabetes and COVID-19, among other pathologies that also increase COVID-19 severity.…”

Section: Obesity and The Ongoing Coronavirus Disease 2019 Crisismentioning

confidence: 99%

Diet Impact on Obesity beyond Calories and Trefoil Factor Family 2 (TFF2) as an Illustration: Metabolic Implications and Potential Applications

2021

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Obesity is a health problem with increasing impacts on public health, economy and even social life. In order to reestablish the energy balance, obesity management focuses mainly on two pillars; exercise and diet. Beyond the contribution to the caloric intake, the diet nutrients and composition govern a variety of properties. This includes the energy balance-independent properties and the indirect metabolic effects. Whereas the energy balance-independent properties are close to “pharmacological” effects and include effects such as antioxidant and anti-inflammatory, the indirect metabolic effects represent the contribution a diet can have on energy metabolism beyond the caloric contribution itself, which include the food intake control and metabolic changes. As an illustration, we also described the metabolic implication and hypothetical pathways of the high-fat diet-induced gene Trefoil Factor Family 2. The properties the diet has can have a variety of applications mainly in pharmacology and nutrition and further explore the “pharmacologically” active food towards potential therapeutic applications.

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“…A vulnerable endothelium in DM is susceptible to further compromise after COVID-19 infection and can predispose to cardiovascular diseases [ 19 ]. The endothelial dysfunction could also contribute to the hypercoagulability that is noted in severe COVID-19 infection [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Mortality and Clinical Outcomes among Patients with COVID-19 and Diabetes

et al. 2021

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Background Diabetes mellitus (DM) is a decisive risk factor for severe illness in coronavirus disease 2019 (COVID-19). India is home to a large number of people with DM, and many of them were infected with COVID-19. It is critical to understand the impact of DM on mortality and other clinical outcomes of COVID-19 infection from this region. Aims The primary objective of our study was to analyze the mortality rate in people with DM infected with COVID-19. The secondary objectives were to assess the effect of various comorbidities on mortality and study the impact of DM on other clinical outcomes. Methods This is a retrospective study of COVID-19 infected patients admitted to a tertiary care hospital in north India in the early phase of the pandemic. Results Of the 1211 cases admitted, 19 were excluded because of incomplete data, and 1192 cases were finally considered for analysis. DM constituted 26.8% of total patients. The overall mortality rate was 6.1%, and the rate was 10.7% in the presence of diabetes (p < 0.01, OR 2.55). In univariate analysis, increased age, chronic kidney disease (CKD), coronary artery disease (CAD), stroke, and cancer were associated with mortality. On multiple logistic regression, the independent predictors of mortality were CAD, CKD, and cancer. Breathlessness and low SpO2 at presentation, extensive involvement in CXR, and elevated ANC/ALC ratio were also significantly associated with mortality. Conclusions The presence of comorbidities such as DM, hypertension, CAD, CKD, and cancer strongly predict the risk of mortality in COVID-19 infection. Early triaging and aggressive therapy of patients with these comorbidities can optimize clinical outcomes.

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COVID-19 and Diabetes: Understanding the Interrelationship and Risks for a Severe Course

Cited by 160 publications

References 162 publications

The Stress Axis in Obesity and Diabetes Mellitus: An Update

The Stress Axis in Obesity and Diabetes Mellitus: An Update

Diet Impact on Obesity beyond Calories and Trefoil Factor Family 2 (TFF2) as an Illustration: Metabolic Implications and Potential Applications

Mortality and Clinical Outcomes among Patients with COVID-19 and Diabetes

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