Impact of COVID-19 on Kidney of Diabetic Patients

Abstract

Given the current state of COVID-19, it is crucial to reveal its evolving relationship with and effect on different body organ systems and their diseases. The severity and outcome of COVID-19 have a very complex relationship, especially to the vital organs including the kidney, either in their state of health or disease. Additionally, it is well known that diabetes affects the kidney, leading to diabetic nephropathy. The kidney is also affected by different pathological and immunopathological reactions with COVID-19 infection, leading to acute kidney injury. Therefore, this review intended to extract the recent advances, updates, and discoveries about the effects of COVID-19 on diabetic patients and the relationship between COVID-19 invasion and the diabetic kidney and to discuss the current state of knowledge that has not yet been proved or disproved, leading to numerous controversial issues in looking for the effect of COVID-19 associated with diabetes mellitus on the human kidney.

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

“…The results of the study indicated that patients with diabetes (9.8%) were more likely to require admission to the ICU than patients without diabetes. These findings suggest that diabetes and poor glycemic control are significant risk factors for severe COVID-19 illness and are correlated with worse outcomes 5 . Furthermore, microvascular complications in patients with diabetes are linked to a worse prognosis in COVID-19 6 .…”

“…SARS-CoV-19 causes multiple organ damage; however, the kidney is more susceptible to damage due to the expression of ACE2 receptors, which the virus uses to gain entry into the cells 5 . A study published on 18 July 2020, investigated the expression of ACE2 in 49 biopsies of patients with diabetic kidney disease and found that the expression of ACE messenger RNA was significantly increased by a factor of two when compared to healthy control subjects.…”

“…In two studies published in 2022 5 , 6 , the authors reported that individuals with diabetes mellitus and DKD in COVID-19 cases were associated with an increased risk of fatality, greater disease severity, and worse outcomes. One study gathered data from two hospitals, including 1561 individuals who had contracted COVID-19.…”

“…The combination of COVID-19 and DKD poses specific challenges, as SARS-CoV-2 has been shown to target and bind to ACE2 receptors that are highly expressed in the kidneys 5 . This raises the possibility of kidney damage in individuals with DKD who have contracted the virus.…”

“…This raises the possibility of kidney damage in individuals with DKD who have contracted the virus. Previous studies have indicated an increased risk of fatality, greater disease severity, and worse outcomes in individuals with DKD and diabetes who are infected with COVID-19 5 , 6 . Understanding the mechanisms underlying the interaction between SARS-CoV-2, diabetes, and kidney disease is crucial for identifying potential therapeutic targets and improving patient outcomes 7 .…”