Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Dasman, Kuwait.
Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Dasman, Kuwait.
Front Immunol. 2020 Dec 1;11:576818. doi: 10.3389/fimmu.2020.576818. eCollection 2020.
COVID-19 is a disease caused by the coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2), known as a highly contagious disease, currently affecting more than 200 countries worldwide. The main feature of SARS-CoV-2 that distinguishes it from other viruses is the speed of transmission combined with higher risk of mortality from acute respiratory distress syndrome (ARDS). People with diabetes mellitus (DM), severe obesity, cardiovascular disease, and hypertension are more likely to get infected and are at a higher risk of mortality from COVID-19. Among elderly patients who are at higher risk of death from COVID-19, 26.8% have DM. Although the reasons for this increased risk are yet to be determined, several factors may contribute to type-2 DM patients' increased susceptibility to infections. A possible factor that may play a role in increasing the risk in people affected by diabetes and/or obesity is the impaired innate and adaptive immune response, characterized by a state of chronic and low-grade inflammation that can lead to abrupt systemic metabolic alteration. SARS patients previously diagnosed with diabetes or hyperglycemia had higher mortality and morbidity rates when compared with patients who were under metabolic control. Similarly, obese individuals are at higher risk of developing complications from SARS-CoV-2. In this review, we will explore the current and evolving insights pertinent to the metabolic impact of coronavirus infections with special attention to the main pathways and mechanisms that are linked to the pathophysiology and treatment of diabetes.
新型冠状病毒病（COVID-19）是由冠状病毒 SARS-CoV-2（严重急性呼吸综合征冠状病毒-2）引起的疾病，被称为高度传染性疾病，目前在全球 200 多个国家流行。SARS-CoV-2 的主要特征是传播速度快，且急性呼吸窘迫综合征（ARDS）的死亡率较高。糖尿病（DM）、严重肥胖、心血管疾病和高血压患者更容易感染，且 COVID-19 死亡率较高。在 COVID-19 死亡风险较高的老年患者中，有 26.8%患有 DM。尽管尚未确定这种风险增加的原因，但有几个因素可能导致 2 型糖尿病患者更易感染。可能导致糖尿病和/或肥胖患者感染风险增加的一个因素是先天和适应性免疫反应受损，其特征是慢性和低度炎症状态，可导致全身代谢突然改变。与代谢控制良好的患者相比，先前被诊断患有糖尿病或高血糖的 SARS 患者的死亡率和发病率更高。同样，肥胖个体患 SARS-CoV-2 并发症的风险更高。在本次综述中，我们将探讨与冠状病毒感染的代谢影响相关的当前和不断发展的见解，特别关注与糖尿病病理生理学和治疗相关的主要途径和机制。
