Abramczyk Urszula, Kuzan Aleksandra
A. Falkiewicz Specialist Hospital in Wroclaw, 52-114 Wroclaw, Poland.
Department of Medical Biochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland.
J Clin Med. 2021 Mar 2;10(5):1022. doi: 10.3390/jcm10051022.
For almost a year, the major medical problem has been the pandemic caused by the SARS-CoV-2 virus. People with diabetes who contract COVID-19 are likely to experience more serious symptoms than patients without diabetes. This article presents new research about the epidemiology of COVID-19 in a group of patients with diabetes. It details the mortality and prognosis in such patients, as well as the relationship between COVID-19 and the diseases most often coexisting with diabetes: obesity, atherosclerosis, hypertension, and increased risk for infection. It also details how the virus infects and affects patients with hyperglycemia. The context of glycation and receptors for advanced glycation products (RAGE) seems to be of particular importance here. We also present a hypothesis related to the cause-and-effect axis-it turns out that diabetes can be both the cause of the more difficult course of COVID-19 and the result of SARS-CoV-2 infection. The last part of this article discusses the impact of antihyperglycemic drugs on the development of COVID-19 and other pharmacological implications, including which non-classical antihyperglycemic drugs seem to be effective in both the treatment of coronavirus infection and glucose homeostasis, and what strategies related to RAGE and glycation should be considered.
近一年来,主要的医学问题一直是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒引起的大流行。感染新型冠状病毒肺炎(COVID-19)的糖尿病患者可能比非糖尿病患者出现更严重的症状。本文介绍了一组糖尿病患者中COVID-19流行病学的新研究。它详细阐述了此类患者的死亡率和预后,以及COVID-19与最常与糖尿病并存的疾病之间的关系:肥胖、动脉粥样硬化、高血压以及感染风险增加。它还详细说明了病毒如何感染和影响高血糖患者。糖化作用和晚期糖基化终产物受体(RAGE)的背景在此似乎尤为重要。我们还提出了一个与因果轴相关的假设——事实证明,糖尿病既可能是COVID-19病程更艰难的原因,也可能是SARS-CoV-2感染的结果。本文的最后一部分讨论了降糖药物对COVID-19发展的影响以及其他药理学意义,包括哪些非传统降糖药物似乎在治疗冠状病毒感染和维持血糖稳态方面均有效,以及应考虑哪些与RAGE和糖化作用相关的策略。