The
novel coronavirus disease (COVID-19) has scourged the world since its outbreak
in December 2019 in Wuhan, China. The disease tends to be asymptomatic or mild
in nearly 80% of the patients. However, around 5% of the patients tend to have critical
diseases complicated by acute respiratory distress syndrome (ARDS), shock, and
multiple organ failure. The disease tends to be specifically severe in patients
with advancing age and in those with underlying comorbidities. Diabetes
mellitus has emerged as distinctive comorbidity that is associated with severe
disease, acute respiratory distress syndrome, intensive care unit admission,
and mortality in COVID- 19. The impaired innate immune system, underlying
pro-inflammatory milieu, reduced expression of angiotensin-converting enzyme 2
(ACE2), and concomitant use of reninangiotensin- aldosterone system-active
drugs are some of the proposed pathophysiological links between diabetes
mellitus and COVID-19 severity. On the contrary, the presence of active
COVID-19 infection in a patient with underlying diabetes mellitus leads to the
worsening of glucose control. Although glucose control prior to hospital
admission has not been consistently associated with clinical outcomes in
diabetic patients with COVID-19, in-hospital good glycemic control is
associated with a lower rate of complications and all-cause mortality.
Keywords: ACE2, ARDS, Case-fatality rate, Comorbidities, COVID-19, Cytokine storm, Diabetes mellitus, D-dimer, Glycemic control, Hypertension, HbA1c, IL-6, Mortality, Mortality rate, Novel coronavirus disease, Old age, SARS-CoV-2, Shock, T1D, T2D, Thromboembolism.
