COVID-19 and diabetes mellitus

Abstract

COVID-19, a disease caused by the new Coronavirus SARSCoV-2, appeared in China in late 2019 and soon began to spread around the world. SARS-CoV-2 predominantly infects the airways, causing mild to severe symptoms, such as acute respiratory syndrome that can result in organ failure that eventually leads to death. The disease causes mild symptoms in most people, while it is dangerous for newborns, the elderly and immunocompromised people and people with comorbidities. Another epidemic is diabetes, which is growing dramatically worldwide: world estimates say that 463 million people between the ages of 20 and 79 live with diabetes, which over time develops chronic complications and risks of developing serious diseases and death. Diabetes mellitus is a chronic metabolic syndrome caused by an absolute and/or relative lack of insuhn, and is characterized by chronic hyperglycemia accompanied by disorders in the metaboHsm of carbohydrates, fats and proteins. Diabetes mellitus is accompanied by the development of various acute complications that occur suddenly and rapidly and require urgent intervention, and due to poor disease control and long-term hyperglycemia, chronic complications of diabetes occur as a result of damage to various tissues and organs, and are the main cause of morbidity and mortality in people with diabetes. People with diabetes are much more susceptible to SARS-CoV-2 virus infection and have a more severe clinical picture and poorer disease outcome after developing COVID-19. Some possible reasons are that SARS-CoV-2 infection can lead to increased levels of inflammatory mediators in the blood such as inflammatory cytokines, toxic metabolites and lipopolysaccharides and may modulate an already dysregulated immune response in diabetic patients. In addition, virus infection can lead to increased production of reactive oxygen species, fibrosis and acute lung damage, and acute respiratory distress syndrome. ROS production and viral activation of the renin-angiotensin-aldosterone system cause insulin resistance, hyperglycemia and vascular endothelial damage. There is also an increase in coagulation components, fibrinogen and D-dimer, which leads to increased blood viscosity and damage to the vascular endothelium and ultimately all this contributes to the development of cardiovascular problems, thromboemboHsm and disseminated intravascular coagulation (DIG). Drugs to lower blood glucose levels and those to dampen cytokine storm and lower lactate levels are useful for effective therapy in C O V I D patients with diabetes, and what would help prevent the development of the disease are improving metabolic health by changing diet and lifestyle.