期刊
FRONTIERS IN CARDIOVASCULAR MEDICINE
卷 7, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fcvm.2020.629933
关键词
COVID-19; SARS-CoV-2; diabetes; endothelium; oxidative stress; angiotensin converting enzyme-2; inflammation; immune response
资金
- European Union's INTERREG VA Programme [IVA5034]
- CoS: IGN Programme at the University of the Highlands and Islands
- Highlands & Islands Enterprise (HMS) [9353763]
Meta-analyses have shown individuals with diabetes are at higher risk of severe COVID-19 and have higher mortality rates, likely due to dysregulated immune and inflammatory responses. The role of ACE2 expression dynamics in diabetes on COVID-19 severity is still under investigation.
Meta-analyses have indicated that individuals with type 1 or type 2 diabetes are at increased risk of suffering a severe form of COVID-19 and have a higher mortality rate than the non-diabetic population. Patients with diabetes have chronic, low-level systemic inflammation, which results in global cellular dysfunction underlying the wide variety of symptoms associated with the disease, including an increased risk of respiratory infection. While the increased severity of COVID-19 amongst patients with diabetes is not yet fully understood, the common features associated with both diseases are dysregulated immune and inflammatory responses. An additional key player in COVID-19 is the enzyme, angiotensin-converting enzyme 2 (ACE2), which is essential for adhesion and uptake of virus into cells prior to replication. Changes to the expression of ACE2 in diabetes have been documented, but they vary across different organs and the importance of such changes on COVID-19 severity are still under investigation. This review will examine and summarise existing data on how immune and inflammatory processes interplay with the pathogenesis of COVID-19, with a particular focus on the impacts that diabetes, endothelial dysfunction and the expression dynamics of ACE2 have on the disease severity.
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