COVID-19 and metabolic comorbidities: An update on emerging evidences for optimal therapies

Autor: Kaixuan Yan, Yong Yang, Shuang Hua, Ying Xu, Xue Jiang, Jufei Li, Xianglu Rong, Danqi Zou, Dewei Ye
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
AT1R
angiotensin II type 1 receptor
Exacerbation
medicine.medical_treatment
Comorbidity
0302 clinical medicine
RAAS
renin-angiotensin-aldosterone system
ARBs
angiotensin receptor blockers
GGT
gamma-glutamyl transferase
TMPRSS2
transmembrane protease serine 2
AT1aR
angiotensin type 1a receptor
COVID-19
coronavirus disease 2019
TNF
tumor necrosis factor
Mortality rate
Diabetes
General Medicine
MCP-1
monocyte chemotactic protein-1
Metformin
Pharmaceutical Preparations
030220 oncology & carcinogenesis
Hypertension
medicine.drug
medicine.medical_specialty
ACE
angiotensin-converting enzyme
RM1-950
ACE2
angiotensin-converting enzyme 2
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
Article
ACEIs
angiotensin-converting enzyme inhibitors
AGT
angiotensinogen
03 medical and health sciences
Metabolic Diseases
Diabetes mellitus
medicine
Animals
Humans
Ang-(1-7)
angiotensin-(1-7)
Intensive care medicine
ARDS
acute respiratory distress syndrome
IFN-γ
interferon-gamma
Th
T-helper
Pharmacology
Polypharmacy
Ang II
angiotensin II
SARS-CoV-2
business.industry
Insulin
Type 2 Diabetes Mellitus
COVID-19
AT2R
angiotensin II type 2 receptor
T2DM
type 2 diabetes mellitus
medicine.disease
COVID-19 Drug Treatment
IL
interleukin
030104 developmental biology
Metabolic comorbidities
Therapeutics. Pharmacology
business
Zdroj: Biomedicine & Pharmacotherapy, Vol 140, Iss, Pp 111685-(2021)
Biomedicine & Pharmacotherapy
ISSN: 0753-3322
Popis: Type 2 diabetes mellitus, obesity, hypertension, and other associated metabolic complications have been demonstrated as a crucial contributor to the enhanced morbidity and mortality of patients with coronavirus disease 2019 (COVID-19). Data on the interplay between metabolic comorbidities and the outcomes in patients with COVID-19 have been emerging and rapidly increasing. This implies a mechanistic link between metabolic diseases and COVID-19 resulting in the exacerbation of the condition. Nonetheless, new evidences are emerging to support insulin-mediated aggressive glucose-lowering treatment as a possible trigger of high mortality rate in diabetic COVID-19 patients, putting the clinician in a confounding and difficult dilemma for the treatment of COVID-19 patients with metabolic comorbidities. Thus, this review discusses the pathophysiological link among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), angiotensin-converting enzyme 2 (ACE2), metabolic complications, and severe inflammation in COVID-19 development, especially in those with multi-organ injuries. We discuss the influence of several routinely used drugs in COVID-19 patients, including anti-inflammatory and anti-coagulant drugs, antidiabetic drugs, renin-angiotensin-aldosterone system inhibitors. Especially, we provide a balanced overview on the clinical application of glucose-lowering drugs (insulin and metformin), angiotensin-converting-enzyme inhibitors, and angiotensin receptor blockers. Although there is insufficient evidence from clinical or basic research to comprehensively reveal the mechanistic link between adverse outcomes in COVID-19 and metabolic comorbidities, it is hoped that the update in the current review may help to better outline the optimal strategies for clinical management of COVID-19 patients with metabolic comorbidities.
Databáze: OpenAIRE
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