Abstract

MORENO-GONZALEZ, Janette G. et al. COVID-19, diabetes, and the immune system. Nova scientia [online]. 2021, vol.13, n.spe.  Epub May 28, 2021. ISSN 2007-0705.  https://doi.org/10.21640/ns.v13ie.2751.

In 2019 in Wuhan province, China, an outbreak of atypical pneumonia was reported with similar symptoms to Severe Acute Respiratory Syndrome (SARS), an outbreak reported in 2003, and Middle East Respiratory Syndrome (MERS) reported in Saudi Arabia in 2012. This emerging disease was caused by a novel coronavirus "Severe Acute Respiratory Syndrome Coronavirus 2" (SARS-CoV-2) or also called COVID-19. Which causes severe respiratory problems and various extrapulmonary manifestations.

At the moment, the high mortality of COVID-19 has been related to the male sex, older adults (>60 years), and preexisting comorbidities of diabetes, obesity, hypertension, and heart problems. Diabetes is a disease characterized by insulin resistance and loss of β cell function in the pancreas, with an impaired immune system due to chronic inflammation. In patients with severe COVID-19 infection, altered secretion of pro-inflammatory cytokines has been observed, if this infection occurs in a diabetic patient who already has an inflammatory state per se, an exacerbated inflammation and multiorgan failure with fatal consequences can be triggered. Several authors hypothesis suggest that hyperglycemia increases the viral replication in patients “diabetic with COVID-19 infection" is necessary to keep adequate glycemic control.

Treatments for COVID-19 had focused on decreasing symptoms, the use of antivirals, anti-inflammatory drugs, monoclonal antibodies and COVID-19 convalescent plasma has shown variable results. A vaccine is needed to control this viral infection, at the moment more than 150 candidates have been developed with efficiency ranges from 70 to 95%, however, the long-term immunity in vaccinated people is still unknown. This review focus on the characteristics of SARS-CoV-2 infection and the immune response in diabetic patients facing COVID-19.

Keywords : cytokine storm; hexosamine; immunity; diabetes; inflammation; hyperglycemia; SARS-CoV-2; serology; antibodies; COVID-19; coronavirus; pandemic; medicine; health.