de Lucena Thays Maria Costa, da Silva Santos Ariane Fernandes, de Lima Brenda Regina, de Albuquerque Borborema Maria Eduarda, de Azevêdo Silva Jaqueline
Department of Genetics, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Department of Genetics, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Laboratory of Immunopathology Keizo Asami (LIKA), Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Diabetes Metab Syndr. 2020 Jul-Aug;14(4):597-600. doi: 10.1016/j.dsx.2020.05.025. Epub 2020 May 12.
The outbreak of the new coronavirus, SARS-CoV-2, causes a respiratory disease and individuals with pre-existing cardiometabolic disorders display worse prognosis through the infection course. The aim of this minireview is to present epidemiological data related to metabolic comorbidities in association with the SARS-CoV-2.
This is a narrative mini-review with Pubmed search until April 23, 2020 using the keywords COVID-19, SARS-CoV-2, treatment of coronavirus and following terms: diabetes mellitus, obesity, arterial hypertension, ACE-inhibitors, cytokine storm, immune response and vitamin D.
Studies indicate that obese individuals are more likely to develop infections, and that adipose tissue serves as a pathogen reservoir. In diabetic individuals higher rate of inflammatory processes is seen due to constant glucose recognition by C type lectin receptors. Hypertensive individuals, usually grouped with other conditions, are treated with drugs to reduce blood pressure mostly through ACEi and ARB, that leads to increased ACE2 expression, used by SARS-CoV-2 for human's cell entry. Until now, the studies have shown that individuals with those conditions and affected by COVID-19 present an uncontrolled release of pro-inflammatory cytokines and an unbalanced immune response, leading to the cytokine storm phenomenon. Vitamin D is highlighted as a potential therapeutic target, because in addition to acting on the immune system, it plays an important role in the control of cardiometabolic diseases.
Currently, since there is no proven and effective antiviral therapy for SARS-CoV-2, the efforts should focus on controlling inflammatory response and reduce the risks of associated complications.
新型冠状病毒SARS-CoV-2的爆发引发了一种呼吸道疾病，患有心血管代谢疾病的个体在整个感染过程中预后较差。本综述的目的是介绍与SARS-CoV-2相关的代谢合并症的流行病学数据。
这是一篇叙述性综述，截至2020年4月23日在PubMed上进行检索搜索，使用的关键词为COVID-19、SARS-CoV-2、冠状病毒治疗以及以下术语：糖尿病、肥胖症、动脉高血压、血管紧张素转换酶抑制剂、细胞因子风暴、免疫反应和维生素D。
研究表明，肥胖个体更容易发生感染，脂肪组织可作为病原体储存库。在糖尿病个体中，由于C型凝集素受体对葡萄糖的持续识别，炎症过程的发生率较高。高血压个体通常与其他疾病合并存在，大多通过使用血管紧张素转换酶抑制剂（ACEi）和血管紧张素受体阻滞剂（ARB）来治疗以降低血压，这会导致血管紧张素转换酶2（ACE2）表达增加，而SARS-CoV-2利用ACE2进入人体细胞。到目前为止，研究表明患有这些疾病且感染COVID-19的个体存在促炎细胞因子的失控释放和免疫反应失衡，从而导致细胞因子风暴现象。维生素D被视为一个潜在的治疗靶点，因为它除了作用于免疫系统外，在心血管代谢疾病的控制中也起着重要作用。
目前，由于尚无针对SARS-CoV-2的经证实有效的抗病毒疗法，应将努力重点放在控制炎症反应和降低相关并发症的风险上。
