Diabetes und COVID-19

Zusammenfassung

Der westliche Lebensstil mit hyperkalorischer, nährstoffarmer Ernährung und körperlicher Inaktivität begünstigt weltweit Übergewicht, Diabetes und Hypertonie. Mit Diabetes und Adipositas verbundenen ist ein erhöhtes Risiko für schweren COVID-19-Krankheitsverlauf und höhere Mortalität als Folge von gestörter Immunantwort, erhöhter Thromboseneigung, vermehrter Bildung von AGEs und RAGE-Aktivierung, von Entzündung und oxidativem Stress. Dies begünstigt eine überschießende und unkontrollierte Zytokinantwort, die verantwortlich ist für das Acute Respiratory Distress Syndrome und Multiorganversagen. Eine Infektion löst Entzündung und Gewebeschädigung aus und führt zu erhöhter Stoffwechselaktivität, um geschädigtes Gewebe und Fremdmaterial zu entfernen. Bei Adipositas und Diabetes sind die Mechanismen zur Aufnahme von Fremdmaterial und Viren in die Zelle deutlich hochreguliert, sodass eine verstärkte Virusinfektion resultieren kann.

Schlüsselwörter

Diabetes mellitus - COVID-19 - Adipositas - Mortalität - Inflammation - Immunsystem - AGEs - ACE2

Publication History

Article published online:
07 October 2021

• Literatur

• 1 Ghosal S, Sinha B, Majumder M, Misra A. Estimation of effects of nationwide lockdown for containing coronavirus infection on worsening of glycosylated haemoglobin and increase in diabetes-related complications: a simulation model using multivariate regression analysis. Diabetes Metab Syndr 2020; 14: 319-323
• 2 Allard R, Leclerc P, Tremblay C, Tannenbaum TN. Diabetes and the severity pandemic influenza A (H1N1) infection. Diabetes Care 2010; 33 (07) : 1491-1493
• 3 Badawi A, Ryoo SG. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. Int J Infect Dis 2016; 49: 129e33
• 4 lraddadi BM, Watson JT, Almarashi A. et al. Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans. Saudi Arabia 2014. Emerg Infect Dis 2016; 22: 49e55
• 5 Yang JK, Feng Y, Yuan MY. et al. Plasma glucose levels and diabetes are independent predictors for mortality and morbidity in patients with SARS. Diabet Med 2006; 23: 623e8
• 6 Matsuyama R, Nishiura H, Kutsuna S. et al. Clinical determinants of the severity of Middle East respiratory syndrome (MERS): a systematic review and meta-analysis. BMC Publ Health 2016; 16: 1203
• 7 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in china: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA 2020; 323 (13) : 1239-1242
• 8 Petrilli CM, Jones SA, Yang J. et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York city: prospective cohort study. BMJ 2020; 369: m1966
• 9 CDC COVID-19 Response Team. Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019–United States, February 12 – March 28, 2020. Morb Mortal Wkly Rep 2020; 69 (13) : 382-386
• 10 Guan WJ, Ni ZY, Hu Y. et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-1720
• 11 Kumar A. Is diabetes mellitus associated with mortality and severity of COVID 19? A meta-analysis. Diabetes Metab Syndr 2020; 14 (04) : 535-545
• 12 Bornstein SR, Rubino F, Khunti K. et al. Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol 2020; 8 (06) : 546-550
• 13 Reddy P, Lent-Schochet D, Ramakrishnana N. et al. Metabolic syndrome is an ammatory disorder: a conspiracy between adipose tissue and phagocytes. Clinica Chimica Acta 2019; 496: 35-44
• 14 Blokhin IO, Lentz SR. Mechanisms of thrombosis in obesity. Curr Opin Hematol 2013; 20 (05) : 437
• 15 Hudson BI, Lippman ME. Targeting RAGE signaling in inflammatory disease. Annu Rev Med 2018; 69: 349-364
• 16 Guo W, Li M, Dong Y. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020; e3319 . 10.1002/dmrr.3319
• 17 Angelidi AM, Belanger MJ, Mantzoros CS. Commentary: COVID-19 and diabetes mellitus: what we know, how our patients should be treated now, and what should happen next. Metab Clin Exp 2020; 107: 154245
• 18 Sardu C, D’Onofrio N, Balestrieri ML. et al. Outcomes in Patients With Hyperglycemia Affected by COVID-19: Can We Do More on Glycemic Control?. Diabetes Care 2020; dc200723 . 10.2337/dc20-0723
• 19 Yang Y, Cai Z, Zhang J. Insulin Treatment May Increase Adverse Outcomes in Patients With COVID-19 and Diabetes: A Systematic Review and Meta-Analysis. Front Endocrinol 2021
• 20 Pal R, Bhansali A. COVID-19, diabetes mellitus and ACE2: the conundrum. Diabetes Res Clin Practice 2020; 162: 1-2
• 21 Mizuiri S, Hemmi H, Arita M. et al. Expression of ACE and ACE2 in individuals with diabetic kidney disease and healthy controls. Am J Kidney Dis 2008; 51 (04) : 613-623
• 22 Hoffmann M, Kleine-Weber H, Schroeder S. et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020; 181 (02) : 271-280.e8
• 23 Wang K, Chen W, Zhou YS. et al. SARS-CoV-2 invades host cells via a novel route: CD147-spike protein. BioRxiv [preprint] 2020
• 24 Li J, Ni M, Lee B. et al. The unfolded protein response regulator GRP78 / BiP is required for endoplasmic reticulum integrity and stress-induced autophagy in mammalian cells. Cell Death Differ 2008; 15 (09) : 1460-1471