Impact of diabetes mellitus on clinical outcomes in patients affected by Covid-19

• Published in: Cardiovascular diabetology Vol. 19; no. 1; pp. 76 - 4
• Main Authors: Sardu, Celestino, Gargiulo, Giuseppe, Esposito, Giovanni, Paolisso, Giuseppe, Marfella, Raffaele
• Format: Journal Article
• Language: English
• Published: England BioMed Central 11.06.2020; BMC
• Subjects: Alveoli; Antibodies; Antibodies, Monoclonal, Humanized - pharmacology; Antibodies, Monoclonal, Humanized - therapeutic use; Betacoronavirus - metabolism; Blood Glucose - drug effects; Blood Glucose - metabolism; Clinical outcomes; Coronavirus Infections - blood; Coronavirus Infections - drug therapy; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; Cytokines; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Disease transmission; Glycemic Index - drug effects; Glycemic Index - physiology; Homeostasis; Humans; Infections; Infectious diseases; Inflammation; Insulin resistance; Intensive care; Interleukin 6; Interleukin 6 receptors; Lung diseases; Micro-vascular disease; Monoclonal antibodies; Mortality; Pandemics; Pneumonia; Pneumonia, Viral - blood; Pneumonia, Viral - drug therapy; Pneumonia, Viral - epidemiology; Receptors, Interleukin-6 - antagonists & inhibitors; Receptors, Interleukin-6 - blood; SARS-CoV-2; Several disease; Severe acute respiratory syndrome coronavirus 2; Treatment Outcome; Type 2 diabetes mellitus; China; Micro-vascular disease; Type 2 diabetes mellitus; Covid-19; Several disease
• DOI: 10.1186/s12933-020-01047-y
• ISSN: 1475-2840

A possible association could exist between type 2 diabetes mellitus (T2DM) and Coronavirus-19 (Covid-19) infection. Indeed, patients with T2DM show high prevalence, severity of disease and mortality during Covid-19 infection. However, the rates of severe disease are significantly higher in patients with diabetes compared with non-diabetes (34.6% vs. 14.2%; p < 0.001). Similarly, T2DM patients have higher rates of need for Intensive Care Unit (ICU, 37.0% vs. 26.7%; p = 0.028). Thus, about the pneumonia of Covid-19, we might speculate that the complicated alveolar-capillary network of lungs could be targeted by T2DM micro-vascular damage. Therefore, T2DM patients frequently report respiratory symptoms and are at increased risk of several pulmonary diseases. In addition, pro-inflammatory pathways as that involving interleukin 6 (IL-6), could be a severity predictor of lung diseases. Therefore, it looks intuitive to speculate that this condition could explain the growing trend of cases, hospitalization and mortality for patients with T2DM during Covid-19 infection. To date, an ongoing experimental therapy with monoclonal antibody against the IL-6 receptor in Italy seems to have beneficial effects on severe lung disease and prognosis in patients with Covid-19 infection. Therefore, should patients with T2DM be treated with more attention to glycemic control and monoclonal antibody against the IL-6 receptor during the Covid-19 infection?