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Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System

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 c...

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Autores principales: Roberts, Jacob, Pritchard, Antonia L., Treweeke, Andrew T., Rossi, Adriano G., Brace, Nicole, Cahill, Paul, MacRury, Sandra M., Wei, Jun, Megson, Ian L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886785/
https://www.ncbi.nlm.nih.gov/pubmed/33614744
http://dx.doi.org/10.3389/fcvm.2020.629933
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author Roberts, Jacob
Pritchard, Antonia L.
Treweeke, Andrew T.
Rossi, Adriano G.
Brace, Nicole
Cahill, Paul
MacRury, Sandra M.
Wei, Jun
Megson, Ian L.
author_facet Roberts, Jacob
Pritchard, Antonia L.
Treweeke, Andrew T.
Rossi, Adriano G.
Brace, Nicole
Cahill, Paul
MacRury, Sandra M.
Wei, Jun
Megson, Ian L.
author_sort Roberts, Jacob
collection PubMed
description 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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spelling pubmed-78867852021-02-18 Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System Roberts, Jacob Pritchard, Antonia L. Treweeke, Andrew T. Rossi, Adriano G. Brace, Nicole Cahill, Paul MacRury, Sandra M. Wei, Jun Megson, Ian L. Front Cardiovasc Med Cardiovascular Medicine 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. Frontiers Media S.A. 2021-02-03 /pmc/articles/PMC7886785/ /pubmed/33614744 http://dx.doi.org/10.3389/fcvm.2020.629933 Text en Copyright © 2021 Roberts, Pritchard, Treweeke, Rossi, Brace, Cahill, MacRury, Wei and Megson. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Roberts, Jacob
Pritchard, Antonia L.
Treweeke, Andrew T.
Rossi, Adriano G.
Brace, Nicole
Cahill, Paul
MacRury, Sandra M.
Wei, Jun
Megson, Ian L.
Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title_full Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title_fullStr Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title_full_unstemmed Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title_short Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System
title_sort why is covid-19 more severe in patients with diabetes? the role of angiotensin-converting enzyme 2, endothelial dysfunction and the immunoinflammatory system
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886785/
https://www.ncbi.nlm.nih.gov/pubmed/33614744
http://dx.doi.org/10.3389/fcvm.2020.629933
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