Li Gerui, Chen Ze, Lv Zhan, Li Hang, Chang Danqi, Lu Jinping
Department of Geratology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China.
Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, China.
Int J Endocrinol. 2021 Apr 1;2021:7394378. doi: 10.1155/2021/7394378. eCollection 2021.
Coronavirus disease 2019 (COVID-19) is a recently emerged disease with formidable infectivity and high mortality. Emerging data suggest that diabetes is one of the most prevalent comorbidities in patients with COVID-19. Although their causal relationship has not yet been investigated, preexisting diabetes can be considered as a risk factor for the adverse outcomes of COVID-19. Proinflammatory state, attenuation of the innate immune response, possibly increased level of ACE2, along with vascular dysfunction, and prothrombotic state in people with diabetes probably contribute to higher susceptibility for SARS-CoV-2 infection and worsened prognosis. On the other hand, activated inflammation, islet damage induced by virus infection, and treatment with glucocorticoids could, in turn, result in impaired glucose regulation in people with diabetes, thus working as an amplification loop to aggravate the disease. Therefore, glycemic management in people with COVID-19, especially in those with severe illness, is of considerable importance. The insights may help to reduce the fatality in the effort against COVID-19.
2019冠状病毒病（COVID-19）是一种最近出现的疾病，具有强大的传染性和高死亡率。新出现的数据表明，糖尿病是COVID-19患者中最常见的合并症之一。尽管它们之间的因果关系尚未得到研究，但既往糖尿病可被视为COVID-19不良结局的一个危险因素。糖尿病患者的促炎状态、固有免疫反应减弱、血管紧张素转换酶2（ACE2）水平可能升高、血管功能障碍以及血栓前状态，可能导致对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的易感性增加和预后恶化。另一方面，激活的炎症、病毒感染诱导的胰岛损伤以及糖皮质激素治疗，反过来可能导致糖尿病患者的血糖调节受损，从而形成一个放大循环，加重疾病。因此，对COVID-19患者，尤其是重症患者进行血糖管理至关重要。这些见解可能有助于在抗击COVID-19的努力中降低死亡率。
