Title:COVID-19 and Diabetes Mellitus: Potential Metabolic Associations
Volume: 21
Issue: 11
Author(s): Pedro Henrique Abreu da Silva, Andressa Santos Garcia, Fábio Aguiar Alves, André Luis Souza dos Santos*Cátia Lacerda Sodré*
Affiliation:
- Laboratorio de Estudos Avancados de Microrganismos Emergentes e Resistentes (LEAMER), Departamento de Microbiologia Geral, Instituto de Microbiologia Paulo de Goes (IMPG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro,Brazil
- Departamento de Biologia Celular e Molecular (GCM), Instituto de Biologia (IB), Universidade Federal Fluminense (UFF), Niteroi-RJ,Brazil
Keywords:
Covid-19, Diabetes mellitus, ACE2, Hyperglycemia, Glucose control, Medicines.
Abstract: The COVID-19 pandemic turned the SARS-CoV-2 into the main target of scientific research
all around the world. Many advances have already been made, but there is still a long way
to go to solve the molecular mechanisms related to the process of the SARS-CoV-2 infection, as
well as the particularities of the disease, its course and the complex host-pathogen relationships.
However, a lot has been theorized and associated with COVID-19, like the worst prognosis of the
disease among individuals with some comorbidities, like diabetes mellitus. In this perspective, diabetic
patients are repeatedly associated with more severe cases of COVID-19 when compared to
non-diabetic patients. Even though ACE2 (angiotensin-converting enzyme 2) was recognized as
the host cell receptor for both binding and entering of SARS-CoV-2 particles, it was also pointed
out that this enzyme plays an important protective role against pulmonary damage. Therefore, paradoxically
as it may seem, the low baseline level of this receptor in diabetics is directly linked to a
more expressive loss of ACE2 protective effect, which could be one of the possible factors for the
worst prognosis of COVID-19. Still, COVID-19 may also have a diabetogenic effect. From this
point of view, the main topics that will be highlighted are (i) the mechanism of the viral entry, with
special attention to the cellular receptor (ACE2) and the viral binding protein (spike), (ii) the relationship
among the renin-angiotensin system, the infection process and the patients' prognosis, (iii)
the glucose control and the medicines used in this event, and (iv) a brief analysis on diabetes triggered
by COVID-19.
