Liu JW, Huang X, Wang MK, Yang JS. Diabetes and susceptibility to COVID-19: Risk factors and preventive and therapeutic strategies. World J Diabetes 2024; 15(8): 1663-1671 [PMID: 39192862 DOI: 10.4239/wjd.v15.i8.1663]
Corresponding Author of This Article
Ming-Ke Wang, MD, PhD, Associate Chief Physician, Naval Medical Center, Naval Medical University, No. 338 Huaihai West Road, Changning District, Shanghai 200052, China. wmke021@163.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Aug 15, 2024; 15(8): 1663-1671 Published online Aug 15, 2024. doi: 10.4239/wjd.v15.i8.1663
Diabetes and susceptibility to COVID-19: Risk factors and preventive and therapeutic strategies
Jing-Wen Liu, Xiao Huang, Ming-Ke Wang, Ji-Shun Yang
Jing-Wen Liu, School of Pharmacy, Bengbu Medical University, Bengbu 233000, Anhui Province, China
Jing-Wen Liu, Xiao Huang, Ming-Ke Wang, Ji-Shun Yang, Naval Medical Center, Naval Medical University, Shanghai 200052, China
Co-first authors: Jing-Wen Liu and Xiao Huang.
Co-corresponding authors: Ming-Ke Wang and Ji-Shun Yang.
Author contributions: Wang MK and Yang JS conceptualized and designed the research; Liu JW, Huang X, Wang MK, and Yang JS wrote and revised the paper; All the authors have read and approved the final manuscript. Liu JW conducted the literature search, organized the literature, and prepared the first draft of the manuscript. Huang X was responsible for organizing the literature on risk factors and treatment strategies related to the susceptibility of diabetic patients to COVID-19, and drew the figure. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as co-first authors of the paper. Both Wang MK and Yang JS conceptualized, proposed, and supervised the whole process of this paper, and played important and indispensable roles in the manuscript preparation and revision as the co-corresponding authors. Wang MK applied for and obtained the funds for this research project. Wang MK conceptualized, designed, and supervised the whole process of the project. He searched the literature, and revised and submitted the early drafts of the manuscript. Yang JS was instrumental and responsible for the comprehensive literature search, preparation, and submission of the current version of the manuscript. This collaboration between Wang MK and Yang JS is crucial for the publication of this manuscript and other manuscripts still in preparation.
Supported byScientific Research Foundation of Shanghai Municipal Health Commission of Changning District, No. 20234Y038.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Ke Wang, MD, PhD, Associate Chief Physician, Naval Medical Center, Naval Medical University, No. 338 Huaihai West Road, Changning District, Shanghai 200052, China. wmke021@163.com
Received: March 27, 2024 Revised: May 22, 2024 Accepted: June 5, 2024 Published online: August 15, 2024 Processing time: 120 Days and 21.7 Hours
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by a novel human coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Diabetes is a well-known risk factor for infectious diseases with high prevalence and increased severity. Here, we elucidated the possible factors for the increased vulnerability of diabetic patients to SARS-CoV-2 infection and the more severe COVID-19 illness. The worsened prognosis of patients with both COVID-19 and diabetes may be attributable to host receptor angiotensin-converting enzyme 2-assisted viral uptake. Moreover, insulin resistance is often associated with impaired mucosal and skin barrier integrity, resulting in mic-robiota dysbiosis, which increases susceptibility to viral infections. It may also be associated with higher levels of pro-inflammatory cytokines resulting from an impaired immune system in diabetics, inducing a cytokine storm and excessive inflammation. This review describes diabetes mellitus and its complications, explains the risk factors, such as disease characteristics and patient lifestyle, which may contribute to the high susceptibility of diabetic patients to COVID-19, and discusses preventive and therapeutic strategies for COVID-19-positive diabetic patients.
Core Tip: This paper hypothesizes that the worsening prognosis of diabetic patients with coronavirus disease 2019 (COVID-19) is attributable to host receptor angiotensin-converting enzyme 2-assisted viral uptake. Insulin resistance is often associated with impaired mucosal and skin barrier integrity, resulting in microbiota dysbiosis, which increases susceptibility to viral infections. It may also be associated with higher levels of pro-inflammatory cytokines resulting from an impaired immune system in diabetic patients, which induces a cytokine storm and excessive inflammation. This review discusses the possible factors contributing to the increased susceptibility of diabetic patients to severe acute respiratory syndrome coronavirus 2 infection and the more severe COVID-19 disease and preventive and therapeutic strategies for COVID-19 in diabetic patients.
