Diabetes and the COVID-19 Pandemic: How Insights from Recent Experience Might Guide Future Management

Stoian, Anca Pantea; Banerjee, Yajnavalka; Rizvi, Ali A.; Rizzo, Manfredi

doi:10.1089/met.2020.0037

Cited by 99 publications

(109 citation statements)

References 12 publications

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“…We speculate that the amelioration of glucose homeostasis in diabetic COVID-19 patients by specific hypoglycemic drugs could result in the amelioration of clinical outcomes with death reduction. However, these data are not reported in trials on COVID-19, and they need to be investigated in further studies [164].…”

Section: Diabetes and Covid-19mentioning

confidence: 95%

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

Sardu

Gambardella

Morelli

et al. 2020

JCM

469

436

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The symptoms most commonly reported by patients affected by coronavirus disease (COVID-19) include cough, fever, and shortness of breath. However, other major events usually observed in COVID-19 patients (e.g., high blood pressure, arterial and venous thromboembolism, kidney disease, neurologic disorders, and diabetes mellitus) indicate that the virus is targeting the endothelium, one of the largest organs in the human body. Herein, we report a systematic and comprehensive evaluation of both clinical and preclinical evidence supporting the hypothesis that the endothelium is a key target organ in COVID-19, providing a mechanistic rationale behind its systemic manifestations.

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Section: Diabetes and Covid-19mentioning

confidence: 95%

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

Sardu

Gambardella

Morelli

et al. 2020

JCM

469

436

View full text Add to dashboard Cite

show abstract

“…The defect of cellular immune response and cytokine storm may play roles in the development of acute respiratory distress syndrome [17]. Since diabetic patients suffer from a less robust immune system due to chronic hyperglycemic and in ammatory states, DM could be a risk factor for COVID-19 progression and death [17][18][19][20] Moreover, there are con icting results regarding the use of angiotensin-converting enzyme 2 (ACE2)-increasing drugs in COVID-19 patients [20,21]. Some studies proposed the harmful effects of these drugs on infection severity while the other ones found the drugs useful for preventing pneumonia and the risk of mortality [16,22].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of DM and CVD was recorded respectively 19% and 8% in hospitalized patients and 31% and 24% in non-survivors [38], indicating a higher prevalence of comorbidities in infected non-survivors in agreement with our ndings. Moreover, DM has been declared as one of the most common comorbidities in deceased COVID-19 patients in some of the European countries [18].…”

Section: Discussionmentioning

confidence: 99%

Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease

Rastad

Karim

Ejtahed

et al. 2020

Preprint

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Background: Diabetes mellitus (DM) and cardiovascular disease (CVD) are present in a large number of patients with novel Coronavirus disease 2019 (COVID-19). We aimed to determine the risk and predictors of in-hospital mortality from COVID-19 in patients with DM and CVD.Methods: This retrospective cohort study included hospitalized patients aged ≥ 18 years with confirmed COVID-19 in Alborz province, Iran, from 20 February 2020 to 25 March 2020. Data on demographic, clinical and outcome (in-hospital mortality) data were obtained from electronic medical records. Self-reported comorbidities were classified into the following groups: “DM” (having DM with or without other comorbidities), “only DM” (having DM without other comorbidities), “CVD” (having CVD with or without other comorbidities), “only CVD” (having CVD without other comorbidities), and “having any comorbidity”. Multivariate logistic regression models were fitted to quantify the risk and predictors of in-hospital mortality from COVID-19 in patients with these comorbidities.Results: Among 2957 patients with COVID-19, 2656 were discharged as cured, and 301 died. In multivariate model, DM (OR: 1.62 (95%CI: 1.14-2.30)) and only DM (1.69 (1.05-2.74)) increased the risk of death from COVID-19; but, both CVD and only CVD showed non-significant associations (p>0.05). Moreover, “having any comorbidities” increased the risk of in-hospital mortality from COVID-19 (OR: 2.66 (95%CI: 2.09 -3.40)). Significant predictors of mortality from COVID-19 in patients with DM were lymphocyte count, creatinine and C-reactive protein (CRP) level (all P- values < 0.05).Conclusions: Our findings suggest that diabetic patients have an increased risk of in-hospital mortality following COVID-19; also, lymphocyte count, creatinine and CRP concentrations could be considered as significant predictors for the death of COVID-19 in these patients.

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“…There is currently no data on the effect of a pandemic on IVI clinic visit. The risk for mortality from COVID-19 rises substantially in individuals older than 65 years of age (12), those living in skilled nursing facilities (13) and individuals with co-morbidities such as diabetes (14) and obesity (15). As the two major indications for iterative IVI are neovascular AMD and diabetic ocular complications (16)(17)(18), these individuals are precisely those at highest risk for COVID-19 associated mortality.…”

Section: Discussionmentioning

confidence: 99%

The Writing On The Wall Intravitreal Injection Compliance During The COVID-19 Pandemic and Its Foreseeable Consequences

Weill

Brosh

et al. 2020

Preprint

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Background: Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents have become the most prevalent intraocular procedure as they represent the major therapeutic modality for prevalent retinal conditions such as age-related macular degeneration (AMD) and diabetic retinopathy. Effective therapy requires adherence to a schedule of iterative IVI as well as routine clinic appointments. The ongoing Coronavirus disease 2019 (COVID-19) pandemic has resulted in the reduction of attendance at scheduled clinics visits and IVI. In this study we attempted to analyze the effect of COVID-19 on compliance with anti-VEGF therapy.Methods: A total of 636 eyes received injections during a four-week period of the COVID-19 outbreak in the Retina Clinic. The number of clinic visits for IVI during one month from March 15 to April 14 of 2020 was compared to the similar time period in each of the last four years.Results: The study demonstrates a decrease in clinic visits for IVI when compared with the same four-week interval in the four previous years. Based on the trend of the previous four years, 10.2% of the year’s total was expected for this time period. Using this model, the 636 reported number of injections for the March-April, 2020 period was ~ 5%. This represents a decrease of ~50% of the expected IVI for this time period.Conclusion: The COVID-19 outbreak in Israel severely impacted compliance with anti-VEGF treatments.

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Diabetes and the COVID-19 Pandemic: How Insights from Recent Experience Might Guide Future Management

Cited by 99 publications

References 12 publications

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

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

Risk and predictors of in-hospital mortality from COVID-19 in patients with diabetes and cardiovascular disease

The Writing On The Wall Intravitreal Injection Compliance During The COVID-19 Pandemic and Its Foreseeable Consequences

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