COVID-19 pandemic, coronaviruses, and diabetes mellitus

Abstract

The pandemic of coronavirus disease (COVID-19), a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is causing substantial morbidity and mortality. Older age and presence of diabetes mellitus, hypertension, and obesity significantly increases the risk for hospitalization and death in COVID-19 patients. In this Perspective, informed by the studies on SARS-CoV-2, Middle East respiratory syndrome (MERS-CoV), and the current literature on SARS-CoV-2, we discuss potential mechanisms by which diabetes modulates the host-viral interactions and host-immune responses. We hope to highlight gaps in knowledge that require further studies pertinent to COVID-19 in patients with diabetes.

Hypertension, Thrombosis, Kidney Failure, and Diabetes: Is COVID-19 an Endothelial Disease? A Comprehensive Evaluation of Clinical and Basic Evidence

“…Diabetes mellitus is a frequent co-morbidity and a cause of worse prognosis in COVID-19 patients [12,[144][145][146][147][148]. Indeed, evaluating pneumonia cases of unknown causes reported in Wuhan and in patients with history of exposure to Huanan seafood market before Jan 1, 2020, 20% had diabetes [85].…”

Biological plausibility for interactions between dietary fat, resveratrol, ACE2, and SARS-CoV illness severity

“…ACE2 and SARS-CoV. With ACE2 as the cellular receptor for SARS-CoV, the interaction between the virus and ACE2 impacts its entrance and clearance (29,45). ACE is responsible for the cleavage of AngI into AngII (34,37), and following this process, ACE2 generates Ang (16,23,29,30,39,41,43) from a single residue cleavage of AngII and then acts as a negative regulator (8).…”

“…Furthermore, there is an association between HFD consumption and risk of developing diabetes mellitus (DM), suggesting that individuals with DM are more likely to consume an HFD (9,36). As such, this proposed mechanism could add to the body of knowledge seeking to explain why SARS-CoV illness severity is greater in individuals with DM as well as in individuals with hypertension (HTN) (29). In addition, ACE2 genetic variations contribute to type 2 DM and HTN risk, and thus high-risk genetic variants are more prevalent in these populations.…”

“…Eighty percent of the genetic sequence of SARS-CoV (2003) is identical to SARS-CoV-2, the virus responsible for the global pandemic caused by the infectious disease COVID-19. The pathophysiology of CoV involves receptor-binding and proteolysis; these processes result in virus-cell fusion as previously detailed elsewhere (29). A key component of virus pathogenesis for SARS-CoV involves the cellular receptor angiotensin converting enzyme-2 (ACE2) (23,43).…”

SARS-CoV-2 receptor networks in diabetic and COVID-19 associated kidney disease

“…Using scRNAseq data, we defined the cellular expression of ACE2 in proximal tubular epithelial cells (PTEC), characterized the cellular programs associated with ACE2 and its regulation in DKD, BKVN and COV-AKI, mapped the ACE2 associated changes to emerging data on SARS-CoV-2 induced cellular responses and tested the associations with RAAS medication exposure ( Figure 1). Our study focused on DKD since COVID-19 disproportionally affects individuals with diabetes and kidney disease 1,3,7,11,22,23 , and research kidney biopsies were available in a comprehensive DKD cohort for scRNAseq profiling and analysis. The DKD analyses could identify underlying mechanisms of excessive risk associated with COVID-19 in patients with diabetes or chronic kidney disease, with the studies in BKVN and COV-AKI establishing the link between DKD and virus-associated kidney disease.…”