Department of Medical and Surgical Sciences, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy.
Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Front Endocrinol (Lausanne). 2022 Aug 19;13:974540. doi: 10.3389/fendo.2022.974540. eCollection 2022.
Since December 2019, a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread around the world, causing the coronavirus 2019 (COVID-19) pandemic. From the beginning, SARS-CoV-2 has put a strain on the health system. In fact, many patients have had severe forms of the disease with the need for hospitalization due to respiratory failure. To contain the pandemic, the most widely used approach has been lockdowns. Social restrictions have been reduced thanks to the development of vaccines and targeted therapies. However, fatal events still occur among people at high risk of serious infection, such as patients with concomitant diabetes. Different mechanisms have been proposed to explain the poor prognosis of patients with diabetes and COVID-19, but the specific cause is unclear. It is now known that insulin resistance, inflammation, and cytokine storm are involved. Moreover, SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptors to enter cells. This receptor is expressed on pancreatic beta cells and, during infection, it appears that receptor involvement may induce hyperglycemia in patients with or without diabetes. In this study, we discuss the mechanisms underlying the poor prognosis in people with COVID-19 and diabetes and what may improve the outcome in these patients.
自 2019 年 12 月以来，一种新型冠状病毒，称为严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2），已在全球范围内传播，导致了 2019 年冠状病毒病（COVID-19）大流行。从一开始，SARS-CoV-2 就给卫生系统带来了压力。事实上，许多患者因呼吸衰竭而患有严重疾病，需要住院治疗。为了控制大流行，最广泛使用的方法是封锁。由于疫苗和靶向治疗的发展，社会限制已经减少。然而，在有严重感染风险的人群中，如伴有糖尿病的患者，仍有致命事件发生。已经提出了不同的机制来解释糖尿病和 COVID-19 患者预后不良的原因，但具体原因尚不清楚。现在已知胰岛素抵抗、炎症和细胞因子风暴与此有关。此外，SARS-CoV-2 使用血管紧张素转换酶 2 受体进入细胞。该受体在胰腺β细胞上表达，在感染过程中，似乎受体的参与可能会导致糖尿病患者和非糖尿病患者的血糖升高。在这项研究中，我们讨论了 COVID-19 和糖尿病患者预后不良的潜在机制，以及可能改善这些患者结局的因素。
