Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection (original) (raw)
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No Evidence of Long-Term Disruption of Glycometabolic Control After SARS-CoV-2 Infection
The Journal of Clinical Endocrinology & Metabolism, 2021
Purpose To assess whether dysglycemia diagnosed during severe acute respiratory syndrome coronavirus 2 pneumonia may become a potential public health problem after resolution of the infection. In an adult cohort with suspected coronavirus disease 2019 (COVID-19) pneumonia, we integrated glucose data upon hospital admission with fasting blood glucose (FBG) in the year prior to COVID-19 and during postdischarge follow-up. Methods From February 25 to May 15, 2020, 660 adults with suspected COVID-19 pneumonia were admitted to the San Raffaele Hospital (Milan, Italy). Through structured interviews/ medical record reviews, we collected demographics, clinical features, and laboratory tests upon admission and additional data during hospitalization or after discharge and in the previous year. Upon admission, we classified participants according to American Diabetes Association criteria as having (1) preexisting diabetes, (2) newly diagnosed diabetes, (3) hyperglycemia not in the diabetes ran...
Glycemic control in an undiagnosed diabetes mellitus patient with Coronavirus Disease 2019
Nigerian Journal of Medicine, 2020
IntRoductIon Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It presents with symptoms with severity ranging from a mild flu-like illness to severe viral pneumonia that is potentially fatal. [1,2] Symptoms may start from 2 days to 2 weeks following exposure to the virus, with some of the patients being asymptomatic. [3] Diabetes mellitus is characterized by high blood glucose concentration resulting from defects in insulin secretion, insulin action, or both. [4] The relationship between diabetes and infection has long been clinically recognized. [5] Nevertheless, the fact remains that controversies exist regarding whether diabetes mellitus itself indeed increases susceptibility and impacts outcomes from infections, including SARS-CoV-2, or the renal and cardiovascular comorbidities that are often associated with diabetes are the main factors involved. [6] Despite the ample publications and reports on blood sugar control in different illnesses, a literature search on blood sugar patterns in COVID-19 patients with severe disease did not show any report. Scarce data exist on glucose metabolism and the development of acute complications of diabetes mellitus in patients with COVID-19. Hence, we reported a case of a 52-year-old Nigerian man known hypertensive heart disease patient with undiagnosed diabetes mellitus who presented with severe COVID-19 in heart failure and difficult to control blood sugar until the 10 th day. case RePoRt A 52-year-old male civil servant obese, known hypertensive heart disease patient who presented to our emergency triage unit with complaints of fever, cough, difficulty with breathing, Diabetes mellitus in coronavirus disease 2019 (COVID-19) patients is associated with poor outcomes due to poorly understood reasons inclusive of blood sugar patterns. Hence, we report a case of a 52-year-old Nigerian man known hypertensive heart disease patient, previously undiagnosed diabetes mellitus patient with difficulty in blood sugar control, heart failure, and persistent severe acute respiratory syndrome coronavirus 2 8 weeks after he tested positive. A 52-year-old male civil servant obese, known hypertensive heart disease patient presented with complaints of fever, cough, difficulty with breathing, headache, and generalized body weakness. At presentation, he had respiratory distress with low oxygen saturation of 78% and hyperglycemia (blood sugar of 40 mmol/l). His body mass index was 35.9 kg/m 2. Chest radiography showed ground-glass appearance with cardiomegaly. Over the next 10 days on admission, his blood sugar fluctuated between hyperglycemia and an episode of hypoglycemia with occasional euglycemia and had glycated hemoglobin of 10.8%. The full blood count was normal, electrolyte, urea and creatinine showed mild elevation of the urea and creatinine, other parameters were normal, while the lipid profile showed hypercholesterolemia. He received multiple doses of insulin, anti-hypertensive, lopinavir/ ritonavir, methylprednisolone, and azithromycin. The patient was weaned off oxygen after 10 days and discharged home 15 days after admission. This case report highlighted the challenges that may face a patient with undiagnosed diabetes mellitus and COVID-19. It also brings forth the need to expand research options in COVID-19 and risk factors associated with the disease as the world strives to control the global pandemic.
Nutrition & Diabetes
Background COVID-19, an infectious disease caused by SARS-CoV-2, was shown to be associated with an increased risk of new-onset diabetes. Mechanisms contributing to the development of hyperglycemia are still unclear. We aimed to study whether hyperglycemia is related to insulin resistance and/or beta cell dysfunction. Materials and methods Survivors of severe COVID-19 but without a known history of diabetes were examined at baseline (T0) and after 3 (T3) and 6 (T6) months: corticosteroids use, indirect calorimetry, and OGTT. Insulin response and sensitivity (IS) were expressed as insulinogenic (IGI), disposition (DI), and Matsuda insulin sensitivity index (ISI). Resting energy expenditure (REE) and respiratory quotient (RQ) was calculated from the gas exchange and nitrogen losses. Results 26 patients (out of 37) with complete outcome data were included in the analysis (age ~59.0 years; BMI ~ 30.4, 35% women). Patients were hypermetabolic at T0 (30.3 ± 4.0 kcal/kg lean mass/day, ~120...
Metabolic Wellbeing and Covid-19
International Journal of Clinical Endocrinology and Metabolism, 2020
The effects of infection with SARS-CoV-2 on host health are complex and major differences in the severity of the disease are observed. The best choices, nevertheless, are prevention and management. The main functions of genomic metabolic processes regulated by various physiological mechanisms are defi ned by the metabolic health of a person. Disordered genomic metabolic processes and a reduction in metabolic health are triggered by disruption of these mechanisms. Weaknesses health is the main risk factor for extreme COVID-19. It is probable that potential physiological changes induced by metabolic syndrome and T2D will overcap with COVID-19, potentially exacerbating the course of the disease. Although chronic diabetes hyperglycaemia contributes to harm that can exacerbate the path of the disease in COVID-19, recent research indicates that in patients with COVID-19 and T2D, dysregulated glucose by itself is counterproductive. To regulate the host infl ammatory response, to reduce tissue susceptibility to infl ammatory damage signals and to maintain physiological function during the extreme and critical phase of infection, glycaemic control is essential.
Diabetologia, 2020
To the Editor: We welcome the letters by Sardu et al [1] and Lepper et al [2] on our paper entitled 'Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study' [3]. Sardu et al found that the change in blood glucose concentration between admission and 24 h was associated with coronavirus disease-2019 (COVID-19) outcome in 132 Italian hyperglycaemic (i.e. blood glucose >7.7 mmol/l on admission) patients hospitalised for both severe and non-severe disease [1]. In addition, Lepper et al reported data on an impressive cohort of nearly 7000 patients with community-acquired pneumonia (CAP) and A complete list of the CORONADO trial investigators is provided in the Electronic supplementary material (ESM).
Journal of diabetes & metabolism, 2021
COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in late December 2019 in Wuhan, China, and has spread to become a pandemic with over 100 million confirmed cases and still growing. The infectious nature and hence, high hospitalization rates and intensive care admissions are resulting in high mortality rates. Alarmingly, COVID-19 infection and virus-induced respiratory dysfunction poses a serious threat to patients with chronic illnesses such as diabetes, Asthma, COPD and obesity. COVID-19 patients with diabetes show higher complication and mortality rate than patients without diabetes. Transient non-severe increased insulin requirement in patients hospitalized for medical conditions such as sepsis or myocardial infarction is a well-known phenomenon. However, extremely high-dose insulin requirement remains a very rarely reported entity, but this showed up in COVID-19 positive cases. Here, we report the case of transitory moderate increase in i...
COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus
Frontiers in Cardiovascular Medicine, 2021
Coronavirus disease 2019 (COVID-19), triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), may lead to extrapulmonary manifestations like diabetes mellitus (DM) and hyperglycemia, both predicting a poor prognosis and an increased risk of death. SARS-CoV-2 infects the pancreas through angiotensin-converting enzyme 2 (ACE2), where it is highly expressed compared to other organs, leading to pancreatic damage with subsequent impairment of insulin secretion and development of hyperglycemia even in non-DM patients. Thus, this review aims to provide an overview of the potential link between COVID-19 and hyperglycemia as a risk factor for DM development in relation to DM pharmacotherapy. For that, a systematic search was done in the database of MEDLINE through Scopus, Web of Science, PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang Data. Data obtained underline that SARS-CoV-2 infection in DM patients is more ...
The complex combination of COVID-19 and diabetes: pleiotropic changes in glucose metabolism
Endocrine, 2021
Purpose Angiotensin converting enzyme 2 (ACE2) is the door for SARS-CoV-2, expressed in critical metabolic tissues. So, it is rational that the new virus causes pleiotropic alterations in glucose metabolism, resulting in the complication of preexisting diabetes's pathophysiology or creating new disease mechanisms. However, it seems that less attention has been paid to this issue. This review aimed to highlight the importance of long-term consequences and pleiotropic alterations in glucose metabolism following COVID-19 and emphasize the need for basic and clinical research in metabolism and endocrinology. Results SARS-CoV-2 shifts cellular metabolism from oxidative phosphorylation to glycolysis, which leads to a decrease in ATP generation. Together with metabolic imbalance, the impaired immune system elevates the susceptibility of patients with diabetes to this deadly virus. SARS-CoV-2-induced metabolic alterations in immune cells can result in hyper inflammation and a cytokine storm. Metabolic dysfunction may affect therapies against SARS-CoV-2 infection. The effective control of metabolic complications could prove useful therapeutic targets for combating COVID-19. It is also necessary to understand the long-term consequences that will affect patients with diabetes who survived COVID-19. Conclusions Since the pathophysiology of COVID-19 is still mostly unknown, identifying the metabolic mechanisms contributing to its progression is essential to provide specific ways to prevent and improve this dangerous virus's detrimental effects. The findings show that the new virus may induce new-onset diabetes with uncertain metabolic and clinical features, supporting a potential role of COVID-19 in the development of diabetes. Keywords COVID-19 • SARS-CoV-2 • Diabetes • Glucose metabolism • Long-term consequences
Background Hyperglycaemia was shown to be among the features of severe acute COVID-19 infection both in the acute and convalescence period. Mechanisms contributing to its development and/or maintenance in a post-COVID phase are still unclear. Materials and Methods Survivors of severe COVID-19 but without a known history of diabetes were examined at baseline (T0) and after 3 (T3) and 6 (T6) months: indirect calorimetry and OGTT. Insulin response and sensitivity (IS) were expressed as insulinogenic (IGI), disposition (DI), and Matsuda insulin sensitivity index (ISI), respectively. Resting energy expenditure (REE) was calculated using the Weir and Harris-Benedict equation and substrate preference using the respiratory quotient (RQ) and nitrogen losses. Results Thirty-two patients (12 women) were available for the analyses at T0 and 26 at T6. Baseline examination was within 21±6.5 days after COVID-19 diagnosis. Patients were hypermetabolic at baseline (30.7 ± 4.3 kcal/kg lean mass/day, ...