COVID‐19 and Diabetes Mellitus: Unveiling the Interaction of Two Pandemics

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ByCrossFitMay 4, 2020

This brief March 2020 editorial, published alongside a study by W. Guo et al., summarizes the significance of high rates of diabetes in the context of the COVID-19 epidemic.

Guo et al. indicate diabetes increases the severity and mortality rate of COVID-19, which is similar to the outcomes seen with the SARS and H1N1 epidemics (1). Given that diabetes is highly prevalent and SARS-CoV-2 highly transmissible, diabetes may significantly increase the COVID-19 disease burden.

Diabetics, as well as those with obesity and other metabolic disorders, present with chronic low-grade inflammation, as evidenced by elevated levels of IL-6, fibrinogen, C-reactive protein, and D-dimer. These changes increase risk of the cytokine storm that is the direct cause of death in many COVID-19 patients. Many of the drugs being tested to treat or prevent COVID-19 mortality — including tocilizumab, siltuximab, and others like them — suppress IL-6 activity, emphasizing the significance of the elevated levels seen in diabetics.

The relationship between COVID-19 and diabetes may be bidirectional. The SARS-CoV-2 virus enters cells via ACE2 present in both liver and pancreas cells (2). Viral infection of these cells impairs insulin secretion and glycemic control, thereby worsening the inflammatory state associated with diabetes.

The editorial authors conclude there are closer and more substantial links between diabetes and COVID-19 than are initially apparent.

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Grant Shymske
May 5th, 2020 at 10:34 pm
Commented on: COVID‐19 and Diabetes Mellitus: Unveiling the Interaction of Two Pandemics

Thank you for making this information easily sharable with my athletes.

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