COVID-19 induces new-onset insulin resistance and lipid metabolic dysregulation via regulation of secreted metabolic factors

He, Xiaoyun; Liu, Chenshu; Peng, Jiangyun; Li, Zilun; Li, Fang; Wang, Jian; Hu, Anbin; Peng, Mingying; Huang, Kan; Fan, Dongxiao; Li, Na; Zhang, Fuchun; Cai, Wei; Tan, Xinghua; Huang, Zhongwei; Deng, Xilong; Liu, Yueping; Mo, Xiaoneng; Li, Linghua; Shi, Yawei; Yang, Li; Zhu, Yuan‐Yuan; Wu, Yanrong; Liang, Huihong; Liao, Baolin; Hong, Wei; He, Ruiying; Li, Jiaojiao; Guo, Pengle; Zhuo, Youguang; Zhao, Liang; Hu, Fengyu; Li, Wenxue; Zhu, Wei; Zhang, Zefeng; Guo, Zhiqiang; Zhang, Wei; Hong, Xiqiang; Cai, Weikang; Gu, Ling; Du, Ziwei; Zhou, Yang; Xu, Jin; Zuo, Tao; Deng, Kai; Yan, Li; Chen, Xinwen; Chen, Sifan; Lei, Chunliang

doi:10.1038/s41392-021-00822-x

Cited by 73 publications

(72 citation statements)

References 48 publications

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“…One of the most known and prevalent factors influencing COVID-19 disease progression [ 17 ] is hyperglycemia. COVID-19 disease may cause prolonged uncontrolled elevated blood glucose level [ 18 ] due to COVID-19-induced insulin resistance [ 19 ] and COVID-19-impaired insulin production [ 20 ]. Contrary to COVID-19 non-survivors, patients with positive COVID-19 outcome showed the ability to normalize energy metabolism during the first week of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study

et al. 2022

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Several relatively recently published studies have shown changes in plasma metabolites in various viral diseases such as Zika, Dengue, RSV or SARS-CoV-1. The aim of this study was to analyze the metabolome profile of patients during acute COVID-19 approximately one month after the acute infection and to compare these results with healthy (SARS-CoV-2-negative) controls. The metabolome analysis was performed by NMR spectroscopy from the peripheral blood of patients and controls. The blood samples were collected on 3 different occasions (at admission, during hospitalization and on control visit after discharge from the hospital). When comparing sample groups (based on the date of acquisition) to controls, there is an indicative shift in metabolomics features based on the time passed after the first sample was taken towards controls. Based on the random forest algorithm, there is a strong discriminatory predictive value between controls and different sample groups (AUC equals 1 for controls versus samples taken at admission, Mathew correlation coefficient equals 1). Significant metabolomic changes persist in patients more than a month after acute SARS-CoV-2 infection. The random forest algorithm shows very strong discrimination (almost ideal) when comparing metabolite levels of patients in two various stages of disease and during the recovery period compared to SARS-CoV-2-negative controls.

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Section: Discussionmentioning

confidence: 99%

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study

et al. 2022

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“…In line with our observations, a case report described the occurrence of DM following SARS-CoV-2 infection [ 49 ]. Emerging evidence supports that SARS-CoV-2 may induce hyperglycemia [ 50 ] and new-onset insulin resistance [ 51 ]. More studies are needed to better understand the roles and mechanisms of SARS-CoV-2 infection and COVID-19 in the initiation and progression of diabetes.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 in the pancreas and the impaired islet function in COVID-19 patients

Zhang

Ren

et al. 2022

Emerging Microbes & Infections

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Diabetes mellitus (DM) is one of the most common underlying diseases that may aggravates COVID-19. In the present study, we explored islet function, the presence of SARS-CoV-2 and pathological changes in the pancreas of patients with COVID-19. Oral glucose tolerance tests (OGTTs) and the C-peptide release test demonstrated a decrease in glucose-stimulated C-peptide secretory capacity and an increase in HbA1c levels in patients with COVID-19. The prediabetic conditions appeared to be more significant in the severe group than in the moderate group. SARS-CoV-2 receptors (ACE2, CD147, TMPRSS2 and neuropilin-1) were expressed in pancreatic tissue. In addition to SARS-CoV-2 virus spike protein and virus RNA, coronavirus-like particles were present in the autophagolysosomes of pancreatic acinar cells of a patient with COVID-19. Furthermore, the expression and distribution of various proteins in pancreatic islets of patients with COVID-19 were altered. These data suggest that SARS-CoV-2 in the pancreas may directly or indirectly impair islet function.

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“…New-onset hyperglycemia, worsening of pre-existing hyperglycemia, or even ketoacidosis has been seen in COVID-19 patients in an acute, inpatient setting [4]. The issue of hyperglycemia also has been seen to persist in some patient populations following both serious and mild cases of COVID-19 infection, indicating a possible long-term impact of the virus [5]. One prospective study observed patients while in the hospital and then followed up three and six months after discharge.…”

Section: Discussionmentioning

confidence: 99%

An Unanticipated Worsening of Glycemic Control Following a Mild COVID-19 Infection

Hardin¹,

Keller²,

Kennedy³

et al. 2022

Cureus

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We describe a case of acute-onset worsening of a patient's previously well-controlled type 2 diabetes mellitus (T2DM) following his recovery from a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 78-year-old male with a three-year medical history of well-controlled T2DM (controlled by diet and metformin) presented to the outpatient clinic to discuss his regularly scheduled six-month lab work. He mentioned having a mild coronavirus disease 2019 (COVID-19) infection lasting one week which required no medical treatment approximately two months before his current visit. His labs, taken one week prior to his current visit, were notable for fasting hyperglycemia, 301mg/dL, and an elevated hemoglobin A 1C (HbA 1C ), 11%. A fasting blood glucose level was recorded at his current in-office visit and was found to be 403mg/dL. These findings were not anticipated -our patient reported no change in his meals, medications, or exercise routines. The only notable change he reported between visits was his COVID-19 infection. This case report explores the link between this virus and our patient's exacerbation of his previously well-controlled T2DM. Whether it be through insulin resistance or deficiency (or another unknown mechanism), our patient's prior novel COVID-19 infection could potentially be associated with his unprecedented altered glucose metabolism.

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COVID-19 induces new-onset insulin resistance and lipid metabolic dysregulation via regulation of secreted metabolic factors

Cited by 73 publications

References 48 publications

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study

SARS-CoV-2 in the pancreas and the impaired islet function in COVID-19 patients

An Unanticipated Worsening of Glycemic Control Following a Mild COVID-19 Infection

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