Elsevier

Primary Care Diabetes

Volume 15, Issue 6, December 2021, Pages 899-909
Primary Care Diabetes

Review
The epidemiology, pathophysiological mechanisms, and management toward COVID-19 patients with Type 2 diabetes: A systematic review

https://doi.org/10.1016/j.pcd.2021.08.014Get rights and content

Highlights

  • Diabetics account for a high proportion of COVID-19 patients and have high risks of poor prognosis.

  • Diabetics are more susceptible to COVID-19 and more likely to get a cytokine storm after infection.

  • ACE2 (the receptor of SARS-CoV-2) and RAS (related to ACE2) are more active in diabetic patients.

  • Patients with diabetes should take strict measures of preventing from the COVID-19 risk.

  • It is worth considering to improve the telemedical information system.

Abstract

This review comprehensively summarizes epidemiologic evidence of COVID-19 in patients with Type 2 diabetes, explores pathophysiological mechanisms, and integrates recommendations and guidelines for patient management. We found that diabetes was a risk factor for diagnosed infection and poor prognosis of COVID-19. Patients with diabetes may be more susceptible to adverse outcomes associated with SARS-CoV-2 infection due to impaired immune function and possible upregulation of enzymes that mediate viral invasion. The chronic inflammation caused by diabetes, coupled with the acute inflammatory reaction caused by SARS-CoV-2, results in a propensity for inflammatory storm. Patients with diabetes should be aware of their increased risk for COVID-19.

Keywords

COVID-19
Diabetes
Epidemiology
Pathophysiological mechanism
Management
SARS-CoV-2

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Equal contribution.

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