COVID-19 and diabetes mellitus: how one pandemic worsens the other
COVID-19 and diabetes mellitus: how one pandemic worsens the other
复制标题
DOI：
10.1007/s11154-020-09573-6
复制
发表时间：
2020-08-02
影响因子：
8.2
通讯作者：
Eid, Assaad A.
中科院分区：
文献类型：
--
作者：
Azar, William S.;Njeim, Rachel;Eid, Assaad A.
鉴于现代历史上最具挑战性的公共卫生危机，COVID-19死亡率继续以惊人的速度上升。合并高血压、心血管疾病和糖尿病（DM）的患者似乎更容易出现严重症状，死亡率也更高。在这篇综述中，我们阐明了糖尿病患者对SARS-CoV-2感染更严重的COVID-19疾病的易感性增加的潜在机制。COVID-19糖尿病患者的预后恶化可归因于宿主受体血管紧张素转换酶2（ACE 2）辅助的病毒摄取促进。它还可能与糖尿病患者中存在的促炎细胞因子的较高基础水平相关，这使得响应病毒的高度炎症“细胞因子风暴”成为可能。本综述还提示IL-6和AMPK/mTOR信号通路水平升高与其在加重糖尿病并发症和胰岛素抵抗中的作用之间存在联系。如果进一步研究，这些发现可能有助于为糖尿病合并COVID-19患者确定新的治疗干预策略。
In light of the most challenging public health crisis of modern history, COVID-19 mortality continues to rise at an alarming rate. Patients with co-morbidities such as hypertension, cardiovascular disease, and diabetes mellitus (DM) seem to be more prone to severe symptoms and appear to have a higher mortality rate. In this review, we elucidate suggested mechanisms underlying the increased susceptibility of patients with diabetes to infection with SARS-CoV-2 with a more severe COVID-19 disease. The worsened prognosis of COVID-19 patients with DM can be attributed to a facilitated viral uptake assisted by the host's receptor angiotensin-converting enzyme 2 (ACE2). It can also be associated with a higher basal level of pro-inflammatory cytokines present in patients with diabetes, which enables a hyperinflammatory "cytokine storm" in response to the virus. This review also suggests a link between elevated levels of IL-6 and AMPK/mTOR signaling pathway and their role in exacerbating diabetes-induced complications and insulin resistance. If further studied, these findings could help identify novel therapeutic intervention strategies for patients with diabetes comorbid with COVID-19.