Insulin resistance in COVID-19 and diabetes

Govender, Nalini; Khaliq, Olive P.; Moodley, Jagidesa; Naicker, Thajasvarie

doi:10.1016/j.pcd.2021.04.004

Cited by 94 publications

(79 citation statements)

References 64 publications

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“…Hyperinsulinemia in patients with insulin resistance and diabetes can lead to increased SARS-CoV-2 viral load, as insulin increases membrane expression of ACE2, which functions as a viral dock for entry into cells[ 47 ]. ACE2 is upregulated in initial stages of diabetes as an adaptive mechanism to counter ACE over activity.…”

Section: Insulin Resistance Increases the Severity Of Coivd-19 In Diabetes Patientsmentioning

confidence: 99%

“…The SARS-CoV-2 viral infection enhances ACE2 deficiency, dysregulation between the ‘adverse’ ACE→ATII→ATI axis, and the “protective” ACE2→AT1-7→MAS1 receptor axis would contribute to strengthening the progression of inflammatory and thrombotic processes. The underlying insulin resistance in patients with type 2 diabetes predispose them to COVID-19 by creating more affinity to spike proteins and an increased inflammatory response, leading to more severe forms of infection with increased mortality[ 47 ].…”

Section: Insulin Resistance Increases the Severity Of Coivd-19 In Diabetes Patientsmentioning

confidence: 99%

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Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity

Gangadharan

Ahluwalia

Sigamani³

2021

WJD

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Patients with diabetes are more susceptible to coronavirus disease 2019 (COVID-19), and as a consequence, develop more severe form of disease. This is partly due to a systemic inflammatory state and pro thrombotic milieu seen in metabolic syndrome. In this review, we attempt to explore the pathogenetic links between insulin resistance and COVID-19 disease severity. Insulin resistance is an underlying condition for metabolic syndromes, including type 2 diabetes, which impairs insulin signaling pathways affecting metabolic and cardiovascular homeostasis. A high concentration of circulating insulin shifts the balance to mitogen activated protein kinase (MAPK)-dependent signaling and causes endothelial cell damage. The phosphatidylinositol 3 kinase and MAPK dependent signaling pathways maintain a balance between nitric oxide-dependent vasodilator and endothelin-1 dependent vasoconstriction actions of insulin. Vascular smooth muscle cell dysfunction is responsible for inflammation and blood coagulation leading to microvascular and macrovascular complications in diabetes. Hyperactivity in renin-angiotensin system is implicated in development of islet oxidative stress and subsequent β-cell dysfunction, as it alters the islet blood flow. These deleterious effects of insulin resistance involving altered blood pressure, vascular dysfunction, and inflammation could be associated with increased severity in COVID-19 patients. We conclude that clinical and/or biochemical markers of insulin resistance should be included as prognostic markers in assessment of acute COVID-19 disease.

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Section: Insulin Resistance Increases the Severity Of Coivd-19 In Diabetes Patientsmentioning

confidence: 99%

Section: Insulin Resistance Increases the Severity Of Coivd-19 In Diabetes Patientsmentioning

confidence: 99%

Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity

Gangadharan

Ahluwalia

Sigamani³

2021

WJD

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“…Although there are several factors associated with the pathology of Covid-19, insulin resistance is considered as one of the main risk factors that cause impairment of metabolic functions (Govender et al, 2021). Therefore, people who are suffering from the disorders of insulin resistance such as diabetes and obesity should consume a low carbohydrate diet as it provides a safe and effective way to maintain glycaemic control and evade insulin resistance .…”

Section: Role Of Nutrition In Covid 19 Susceptibility and Severitymentioning

confidence: 99%

Host Genetic Susceptibility and Impacts of Dietary Factors on Covid-19

Ranadeva¹,

Gunathilaka²

2022

IJKIU

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COVID-19, a disease caused by SARS coronavirus 2 (SARS-CoV-2) has been a virus which is causing a global issue due to the fact that it resulted in a pandemic. The SARS coronavirus 2 binds with the angiotensin-converting enzyme 2 (ACE-2) receptors expressed in various human organs including the lungs. The SARC-CoV-2 causes respiratory disease ranging from mild to life-threatening pneumonia. Covid-19 is much feared due to its ultimate outcome such as multi-organ damage as a result of the production of a high level of pro-inflammatory cytokines referred to as “cytokine storm and resulting increased mortality and morbidity. Outcomes of the COVID 19 infection are associated with several factors that include demographic, environmental, behavioural, dietary, and genetic factors. In addition, male gender, ethnicity, older age, obesity, and several chronic diseases affect the severity of the disease. Genetic susceptibility and dietary factors involved with COVID – 19 infectivity are current areas that are widely researched and likely to play a major role. Through Genome Wide Association Studies (GWAS) and other studies done worldwide, scientists have discovered variants related to the susceptibility and severity of COVID-19. Among published reports, the involvement of ACE-2, TMPRSS2, 3p21.31 gene cluster, OAS1, OAS2 and OAS3, TYK2, DPP9, IFNAR2, CCR2 TMEM189–UBE2V1 genes, IFNL4, TLR7, LZTFL1, CCHCR1, CCNG1, ACSF3, FPR1, NKG2C/HLA-E, NLRP3, DNAH7 and CLUAP1, DES and SPEG, STXBP5, TOMM7, WSB1, PIEZO1, SCN5A, APOL1, PRKRA, GC, NADSYN1, VDR, and CYP2R1, PPCDC, VDR, DMGDH is summarized in this review. Similarly, this review concluded the role of nutrition in terms of the importance of a balanced diet and functional foods, micronutrients, probiotics, and how the omega 3/omega 6 ratio helps to prevent the severity of COVID-19.

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“…Intracellular FFA efflux causes inhibition of glycolysis and glucose intolerance [ 38 ]. Ang II causes insulin resistance by increasing oxidative stress [ 40 ], and patients with COVID-19 have insulin resistance due to the increase in Ang II [ 41 ]. As a result of these events, intracellular FFA influx and prolonged NHE activation may accelerate the atherosclerotic process in patients with COVID-19.…”

Section: Relationship Between Lipids Nhe and Covid-19mentioning

confidence: 99%

Strong relationship between cholesterol, low-density lipoprotein receptor, Na+/H+ exchanger, and SARS-COV-2: this association may be the cause of death in the patient with COVID-19

Cüre

Cüre²

2021

Lipids Health Dis

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Lipids have a wide variety and vital functions. Lipids play roles in energy metabolism, intracellular and extracellular signal traffic, and transport of fat-soluble vitamins. Also, they form the structure of the cell membrane. SARS-CoV-2 interacts with lipids since its genetic material contains lipid-enveloped ribonucleic acid (RNA). Previous studies have shown that total cholesterol, high-density lipoprotein, and low-density lipoprotein (LDL) levels are lower in patients with severe novel coronavirus disease 2019 (COVID-19) compared to patients with non-severe COVID-19.Na+/H+ Exchanger (NHE) is an important antiport that keeps the intracellular pH value within physiological limits. When the intracellular pH falls, NHE is activated and pumps H+ ions outward. However, prolonged NHE activation causes cell damage and atherosclerosis. Prolonged NHE activation may increase susceptibility to SARS-CoV-2 infection and severity of COVID-19.In COVID-19, increased angiotensin II (Ang II) due to angiotensin-converting enzyme-2 (ACE2) dysfunction stimulates NHE. Lipids are in close association with the NHE pump. Prolonged NHE activity increases the influx of H+ ions and free fatty acid (FFA) inward. Ang II also causes increased low-density lipoprotein receptor (LDLR) levels by inhibiting proprotein convertase subtilisin/kexin type 9 (PCSK9). Thus, intracellular atheroma plaque formation is accelerated.Besides, SARS-CoV-2 may replicate more rapidly as intracellular cholesterol increases. SARS-CoV-2 swiftly infects the cell whose intracellular pH decreases with NHE activation and FFA movement. Novel treatment regimens based on NHE and lipids should be explored for the treatment of COVID-19.

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Insulin resistance in COVID-19 and diabetes

Cited by 94 publications

References 64 publications

Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity

Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity

Host Genetic Susceptibility and Impacts of Dietary Factors on Covid-19

Strong relationship between cholesterol, low-density lipoprotein receptor, Na+/H+ exchanger, and SARS-COV-2: this association may be the cause of death in the patient with COVID-19

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