Behera Kishore K, Hota Debasish, Mahapatra Ashoka
Department of Endocrinology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Family Med Prim Care. 2020 Sep 30;9(9):4512-4515. doi: 10.4103/jfmpc.jfmpc_710_20. eCollection 2020 Sep.
The clinical manifestation of COVID-19 is diverse, oscillating from mild flu-like symptoms to more severe outcome, such as acute respiratory distress syndrome, multiple organ failure, and death. Advanced age and comorbidities, such as diabetes mellitus, high blood pressure, and history of cerebrovascular accidents are reported to have worse outcome. Chronic inflammation by cytokine storm and direct insult to pancreatic by COVID-19 might be postulated mechanisms of inducing or deteriorating diabetes. Individualized patient-centric treatment and optimal blood sugar control should be made based on disease severity, presence of comorbid condition, and complications related to diabetes, age, and other risk factors. Recent clinical trials have shown some hope to anti-interleukin antibody as a potential therapeutic option against COVID-19 especially in people with severe illness.
新型冠状病毒肺炎(COVID-19)的临床表现多样,从轻微的流感样症状到更严重的后果,如急性呼吸窘迫综合征、多器官功能衰竭和死亡。据报道,高龄以及合并症,如糖尿病、高血压和脑血管意外病史,预后较差。细胞因子风暴引起的慢性炎症以及COVID-19对胰腺的直接损害可能是诱发或加重糖尿病的假定机制。应根据疾病严重程度、合并症情况以及与糖尿病、年龄和其他危险因素相关的并发症,制定以患者为中心的个体化治疗方案并实现最佳血糖控制。最近的临床试验显示,抗白细胞介素抗体作为一种针对COVID-19的潜在治疗选择带来了一些希望,尤其是对重症患者。