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Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications

BACKGROUND: Our understanding of the pathophysiology of the COVID-19 manifestations and evolution has improved over the past 10 months, but the reasons why evolution is more severe in obese and diabetic patients are not yet completely understood. MAIN TEXT: In the present review we discuss the diffe...

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Autores principales: Santos, Andrey, Magro, Daniéla Oliveira, Evangelista-Poderoso, Rosana, Saad, Mario José Abdalla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919999/
https://www.ncbi.nlm.nih.gov/pubmed/33648564
http://dx.doi.org/10.1186/s13098-021-00639-2
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author Santos, Andrey
Magro, Daniéla Oliveira
Evangelista-Poderoso, Rosana
Saad, Mario José Abdalla
author_facet Santos, Andrey
Magro, Daniéla Oliveira
Evangelista-Poderoso, Rosana
Saad, Mario José Abdalla
author_sort Santos, Andrey
collection PubMed
description BACKGROUND: Our understanding of the pathophysiology of the COVID-19 manifestations and evolution has improved over the past 10 months, but the reasons why evolution is more severe in obese and diabetic patients are not yet completely understood. MAIN TEXT: In the present review we discuss the different mechanisms that may contribute to explain the pathophysiology of COVID-19 including viral entrance, direct viral toxicity, endothelial dysfunction, thromboinflammation, dysregulation of the immune response, and the renin–angiotensin–aldosterone system. CONCLUSIONS: We show that the viral infection activates an integrated stress response, including activations of serine kinases such as PKR and PERK, which induce IRS-1 serine phosphorylation and insulin resistance. In parallel, we correlate and show the synergy of the insulin resistance of COVID-19 with this hormonal resistance of obesity and diabetes, which increase the severity of the disease. Finally, we discuss the potential beneficial effects of drugs used to treat insulin resistance and diabetes in patients with COVID-19.
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spelling pubmed-79199992021-03-02 Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications Santos, Andrey Magro, Daniéla Oliveira Evangelista-Poderoso, Rosana Saad, Mario José Abdalla Diabetol Metab Syndr Review BACKGROUND: Our understanding of the pathophysiology of the COVID-19 manifestations and evolution has improved over the past 10 months, but the reasons why evolution is more severe in obese and diabetic patients are not yet completely understood. MAIN TEXT: In the present review we discuss the different mechanisms that may contribute to explain the pathophysiology of COVID-19 including viral entrance, direct viral toxicity, endothelial dysfunction, thromboinflammation, dysregulation of the immune response, and the renin–angiotensin–aldosterone system. CONCLUSIONS: We show that the viral infection activates an integrated stress response, including activations of serine kinases such as PKR and PERK, which induce IRS-1 serine phosphorylation and insulin resistance. In parallel, we correlate and show the synergy of the insulin resistance of COVID-19 with this hormonal resistance of obesity and diabetes, which increase the severity of the disease. Finally, we discuss the potential beneficial effects of drugs used to treat insulin resistance and diabetes in patients with COVID-19. BioMed Central 2021-03-01 /pmc/articles/PMC7919999/ /pubmed/33648564 http://dx.doi.org/10.1186/s13098-021-00639-2 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Santos, Andrey
Magro, Daniéla Oliveira
Evangelista-Poderoso, Rosana
Saad, Mario José Abdalla
Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title_full Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title_fullStr Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title_full_unstemmed Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title_short Diabetes, obesity, and insulin resistance in COVID-19: molecular interrelationship and therapeutic implications
title_sort diabetes, obesity, and insulin resistance in covid-19: molecular interrelationship and therapeutic implications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919999/
https://www.ncbi.nlm.nih.gov/pubmed/33648564
http://dx.doi.org/10.1186/s13098-021-00639-2
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