The effect of diabetes on the risk and mortality of acute lung injury/acute respiratory distress syndrome

Ji, Mingxia; Chen, Mengyan; Hong, Xiaofei; Chen, Tiejiang; Zhang, Ning

doi:10.1097/md.0000000000015095

Cited by 24 publications

(23 citation statements)

References 28 publications

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“…To the best of our knowledge, this is the first meta-analysis considering the DM in COVID-19 infection. Surely, DM s generally associated with a poor prognosis in infective disease [17][18][19][20], but a direct demonstration of this aspect in COVID-19 patients, until now, has been only reported in isolated reports [13][14][15][16] and never analysed comprehensively. However, whether DM increased the risk of infection due to COVID-SARS-19 remains an unresolved question to date and will require further clarification by specific studies.…”

Section: Discussionmentioning

confidence: 99%

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Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome

Roncon

Zuin

Rigatelli

et al. 2020

Journal of Clinical Virology

394

320

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Background: Diabetes mellitus might be associated with severity and death in patients with COVID-19; but its mechanisms are still unknown. Objective: to carry out a systematic review of what has been published so far on mortality in patients with COVID-19 associated with diabetes comorbidity. Methods: A search was carried out in PubMed, Ovid MEDLINE, EMBASE and EMBASE Classic and Google Scholar databases; up to April 2020 using the search medical subheadings (MeSH) terms : "mortality from Coronavirus", "mortality from COVID-19" and "mortality in patients with diabetes by COVID-19". Enrolled studies were assessed independently by two blinded researchers. Studies quality was assessed using the Jedad scale. The articles score equal or greater than two points were considered highly methodological quality. Results: Initially, 65 articles were found and 46 were excluded for not meeting the eligibility criteria. Among the 10 remaining, 3 were excluded because had Jedad score lower than two points. Among the remaining seven, two were excluded because they were meta-analysis. Eventually, ve articles remained for nal analysis. For all, mortality among patients with diabetes was higher than without diabetes. The risk of global mortality among diabetes patients was 8.9 times higher (p<0.0001) than without diabetes The time of diagnosis could be more determining for mortality, meanwhile HB1Ac level was not determining Conclusion: Mortality risk observed by COVID-19 is higher among diabetes patients than healthy age matched peers. This result can be partially explained by hormonal signaling changes, such as blood clotting and abnormal pancreas functioning.

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Section: Discussionmentioning

confidence: 99%

“…Recently. some investigations have focused their attention to the risk of infection in diabetic subjects [20,21]. Despite the prevention of the infection remains the primary concern, also the comprehension of the course of the disease has a pivotal role, especially in different subset of patients, as the diabetics.…”

Section: Discussionmentioning

confidence: 99%

Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome

Roncon

Zuin

Rigatelli

et al. 2020

Journal of Clinical Virology

394

320

View full text Add to dashboard Cite

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“…The low incidence of sepsis-induced ALI has been also observed in patients with diabetes developing sepsis ( 245 – 248 ). However, a recent clinical study indicates that diabetes does not have any impact on sepsis-associated mortality and the 60-days mortality of ALI/ARDS ( 249 ). Diabetes may reduce the incidence of the sepsis-induce ALI/ARDS but not the associated mortality.…”

Section: Pulmonary Innate Immune Response During Bacterial Sepsismentioning

confidence: 99%

Pulmonary Innate Immune Response Determines the Outcome of Inflammation During Pneumonia and Sepsis-Associated Acute Lung Injury

2020

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The lung is a primary organ for gas exchange in mammals that represents the largest epithelial surface in direct contact with the external environment. It also serves as a crucial immune organ, which harbors both innate and adaptive immune cells to induce a potent immune response. Due to its direct contact with the outer environment, the lung serves as a primary target organ for many airborne pathogens, toxicants (aerosols), and allergens causing pneumonia, acute respiratory distress syndrome (ARDS), and acute lung injury or inflammation (ALI). The current review describes the immunological mechanisms responsible for bacterial pneumonia and sepsis-induced ALI. It highlights the immunological differences for the severity of bacterial sepsis-induced ALI as compared to the pneumonia-associated ALI. The immune-based differences between the Gram-positive and Gram-negative bacteria-induced pneumonia show different mechanisms to induce ALI. The role of pulmonary epithelial cells (PECs), alveolar macrophages (AMs), innate lymphoid cells (ILCs), and different pattern-recognition receptors (PRRs, including Toll-like receptors (TLRs) and inflammasome proteins) in neutrophil infiltration and ALI induction have been described during pneumonia and sepsis-induced ALI. Also, the resolution of inflammation is frequently observed during ALI associated with pneumonia, whereas sepsis-associated ALI lacks it. Hence, the review mainly describes the different immune mechanisms responsible for pneumonia and sepsis-induced ALI. The differences in immune response depending on the causal pathogen (Gram-positive or Gram-negative bacteria) associated pneumonia or sepsis-induced ALI should be taken in mind specific immune-based therapeutics.

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“…Acute lung injury (ALI), known as pulmonary inflammation, is a life-threatening clinical condition due to its higher morbidity and mortality worldwide (Ji et al, 2019;Khan et al, 2019). The ALI mainly characterizes with cell infiltration, cytokine production, air-blood barrier permeability increase, pulmonary edema, and pathological damage (Pinheiro et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Protective Effect of Piceatannol Against Acute Lung Injury Through Protecting the Integrity of Air-Blood Barrier and Modulating the TLR4/NF-κB Signaling Pathway Activation

et al. 2020

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Acute lung injury (ALI) is a common and complex inflammatory lung syndrome with higher morbidity and mortality rate. Piceatannol (PIC) has anti-inflammation and anti-oxidant properties. The study was designed to explore the effect and the action mechanisms of PIC on lipopolysaccharide (LPS)-induced ALI. Twenty-four hours after LPS challenge, mice from different treatment groups were euthanized, and the bronchoalveolar lavage fluid (BALF) and lung tissue samples were collected. Then the degree of pulmonary edema, lung pathological changes, myeloperoxidase (MPO) activity, and the production of pro-inflammatory cytokines were detected. Additionally, the messenger RNA (mRNA) expressions associated with cell adhesion molecules and tight junction were analyzed through quantitative real-time (qRT)-PCR, and the TLR4/NF-kB activation was examined by western blot. The results showed that PIC significantly inhibited LPS-induced lung edema, histopathological damage, MPO activity, cell infiltration, and pro-inflammatory cytokines production. Moreover, PIC notably suppressed mRNA expressions associated with inflammation and cell adhesion molecules. Furthermore, PIC also alleviated LPSinduced damage of air-blood barrier through reducing the levels of total proteins in BALF and recovering the expression of occludin and ZO-1 in the lung tissues. We also found that PIC remarkably restrained the LPS-induced TLR4/NF-kB pathway activation in lung tissues. In conclusion, PIC may be potential to treat LPS-induced acute lung injury (ALI) via regulating air-blood barrier and TLR4/NF-kB signaling pathway activation.

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The effect of diabetes on the risk and mortality of acute lung injury/acute respiratory distress syndrome

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 28 publications

Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome

Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome

Pulmonary Innate Immune Response Determines the Outcome of Inflammation During Pneumonia and Sepsis-Associated Acute Lung Injury

Protective Effect of Piceatannol Against Acute Lung Injury Through Protecting the Integrity of Air-Blood Barrier and Modulating the TLR4/NF-κB Signaling Pathway Activation

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