COVID-19 and metabolic comorbidities: An update on emerging evidences for optimal therapies.
COVID-19 and metabolic comorbidities: An update on emerging evidences for optimal therapies.
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COVID-19 和代谢合并症：最佳治疗新证据的更新
DOI：
10.1016/j.biopha.2021.111685
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Ye D
中科院分区：
文献类型：
--
作者：
Hua S;Yang Y;Zou D;Li J;Yan K;Xu Y;Jiang X;Rong X;Ye D
2型糖尿病、肥胖、高血压和其他相关代谢并发症已被证明是2019冠状病毒病（COVID-19）患者发病率和死亡率增加的关键因素。关于代谢合并症与COVID-19患者结局之间相互作用的数据不断涌现并迅速增加。这意味着代谢疾病与COVID-19之间存在机械联系，导致病情恶化。尽管如此，新的证据支持胰岛素介导的积极降糖治疗可能是糖尿病COVID-19患者高死亡率的触发因素，使临床医生在治疗患有代谢合并症的COVID-19患者时陷入混乱和困难的困境。因此，本综述讨论了严重急性呼吸综合征冠状病毒2（SARS-CoV-2），血管紧张素转换酶2（ACE 2），代谢并发症和严重炎症在COVID-19发展中的病理生理学联系，特别是在多器官损伤的情况下。我们讨论了几种常规使用的药物对COVID-19患者的影响，包括抗炎和抗凝药物，抗糖尿病药物，肾素-血管紧张素-醛固酮系统抑制剂。特别是，我们提供了一个平衡的概述降糖药物（胰岛素和二甲双胍），血管紧张素转换酶抑制剂，血管紧张素受体阻滞剂的临床应用。尽管临床或基础研究的证据不足以全面揭示COVID-19不良结局与代谢合并症之间的机制联系，但希望当前综述的更新可能有助于更好地概述COVID-19代谢合并症患者临床管理的最佳策略。
Type 2 diabetes mellitus, obesity, hypertension, and other associated metabolic complications have been demonstrated as a crucial contributor to the enhanced morbidity and mortality of patients with coronavirus disease 2019 (COVID-19). Data on the interplay between metabolic comorbidities and the outcomes in patients with COVID-19 have been emerging and rapidly increasing. This implies a mechanistic link between metabolic diseases and COVID-19 resulting in the exacerbation of the condition. Nonetheless, new evidences are emerging to support insulin-mediated aggressive glucose-lowering treatment as a possible trigger of high mortality rate in diabetic COVID-19 patients, putting the clinician in a confounding and difficult dilemma for the treatment of COVID-19 patients with metabolic comorbidities. Thus, this review discusses the pathophysiological link among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), angiotensin-converting enzyme 2 (ACE2), metabolic complications, and severe inflammation in COVID-19 development, especially in those with multi-organ injuries. We discuss the influence of several routinely used drugs in COVID-19 patients, including anti-inflammatory and anti-coagulant drugs, antidiabetic drugs, renin-angiotensin-aldosterone system inhibitors. Especially, we provide a balanced overview on the clinical application of glucose-lowering drugs (insulin and metformin), angiotensin-converting-enzyme inhibitors, and angiotensin receptor blockers. Although there is insufficient evidence from clinical or basic research to comprehensively reveal the mechanistic link between adverse outcomes in COVID-19 and metabolic comorbidities, it is hoped that the update in the current review may help to better outline the optimal strategies for clinical management of COVID-19 patients with metabolic comorbidities.
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DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
影响因子：
1.9
作者：
Antoniak S;Cardenas JC;Buczek LJ;Church FC;Mackman N;Pawlinski R
通讯作者：
Pawlinski R
影响因子：
29
作者：
Codo, Ana Campos;Davanzo, Gustavo Gastao;Moraes-Vieira, Pedro M.
通讯作者：
Moraes-Vieira, Pedro M.
影响因子：
7.3
作者：
Bhaskar, Sonu;Sinha, Akansha;Kutty, Shelby
通讯作者：
Kutty, Shelby
影响因子：
6.1
作者：
Banu N;Panikar SS;Leal LR;Leal AR
通讯作者：
Leal AR