Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates.
Sharjah Institute for Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates; College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates.
Infect Genet Evol. 2021 Jan;87:104647. doi: 10.1016/j.meegid.2020.104647. Epub 2020 Nov 29.
The devastating pandemic of coronavirus disease 2019 (COVID-19) has caused thousands of deaths and left millions of restless patients suffering from its complications. Increasing data indicate that the disease presents in a severe form in patients with pre-existing chronic conditions like cardiovascular diseases, diabetes, respiratory system diseases, and renal diseases. This denotes that these patients are more susceptible to COVID-19 and have higher mortality rates compared to patients with no comorbid conditions. Several factors can explain the heightened susceptibility and fatal presentation of COVID-19 in these patients, for example, the enhanced expression of the angiotensin-converting enzyme-2 (ACE2) in specific organs, cytokine storm, and drug interactions contribute to the increased morbidity and mortality. Adding to the findings that individuals with pre-existing conditions may be more susceptible to COVID-19, it has also been shown that COVID-19 can induce chronic diseases in previously healthy patients. Therefore, understanding the interlinked relationship between COVID-19 and chronic diseases helps in optimizing the management of susceptible patients. This review comprehensively described the molecular mechanisms that contribute to worse COVID-19 prognosis in patients with pre-existing comorbidities such as diabetes, cardiovascular diseases, respiratory diseases, gastrointestinal and renal diseases, blood disorders, autoimmune diseases, and finally, obesity. It also focused on how COVID-19 could, in some cases, lead to chronic conditions as a result of long-term multi-organ damage. Lastly, this work carefully discussed the tailored management plans for each specific patient population, aiming to achieve the best therapeutic outcome with minimum complications.
2019 年冠状病毒病(COVID-19)大流行造成数千人死亡,使数百万因并发症而不安的患者受苦。越来越多的数据表明,患有心血管疾病、糖尿病、呼吸系统疾病和肾脏疾病等先前存在的慢性疾病的患者病情严重。这表明这些患者更容易感染 COVID-19,死亡率比没有合并症的患者更高。有几个因素可以解释为什么这些患者更容易感染 COVID-19,表现为严重形式,例如,特定器官中血管紧张素转换酶-2(ACE2)的表达增强、细胞因子风暴和药物相互作用导致发病率和死亡率增加。除了发现患有先前存在的疾病的个体可能更容易感染 COVID-19 之外,还表明 COVID-19 可以在以前健康的患者中引发慢性疾病。因此,了解 COVID-19 和慢性疾病之间的相互关系有助于优化易感患者的管理。这篇综述全面描述了导致患有先前存在的合并症(如糖尿病、心血管疾病、呼吸系统疾病、胃肠道和肾脏疾病、血液疾病、自身免疫性疾病)的患者 COVID-19 预后更差的分子机制,并着重讨论了 COVID-19 如何在某些情况下因长期多器官损伤而导致慢性疾病。最后,这项工作仔细讨论了针对每个特定患者群体的定制管理计划,旨在实现最佳治疗效果并最小化并发症。