ReviewFrontiers in cardiovascular medicine2020
Why Is COVID-19 More Severe in Patients With Diabetes? The Role of Angiotensin-Converting Enzyme 2, Endothelial Dysfunction and the Immunoinflammatory System.
Review in Frontiers in cardiovascular medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Diabetes Mellitus, a Leading Comorbidity in COVID-19: an Insight on Pathophysiology, Molecular Interactions, and Comprehensive Management.Current microbiology · 2025Pooled it
- Type 2 diabetes mellitus as a predictor of severe outcomes in COVID-19 - a systematic review and meta-analyses.BMC infectious diseases · 2025Pooled it
- Umbilical cord mesenchymal stromal cells as critical COVID-19 adjuvant therapy: A randomized controlled trial.Stem cells translational medicine · 2021Trial
- Decoding the interplay between COVID-19 and diabetic nephropathy through bioinformatics and systems biology techniques.Biochemistry and biophysics reports · 2025Article
- Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS.Infectious medicine · 2025Review
- Pre-pandemic diabetes and risk of long COVID: longitudinal evidence.Journal of diabetes and metabolic disorders · 2025Article
- Small extracellular vesicles produced from canine adipose-derived mesenchymal stem cells mitigate diabetes mellitus in streptozotocin-induced mice via β-cell revitalization.BMC veterinary research · 2025Article
- A Machine Learning Model for Predicting Intensive Care Unit Admission in Inpatients with COVID-19 Using Clinical Data and Laboratory Biomarkers.Biomedicines · 2025Article
- Neuropsychiatric Manifestations of Long COVID-19: A Narrative Review of Clinical Aspects and Therapeutic Approaches.Life (Basel, Switzerland) · 2025Review
- Potential protective association of the AA genotype and a allele of CXCR4 rs2228014 polymorphism with COVID-19 severity in adult egyptians.BMC infectious diseases · 2024Article
- Role of the receptor for advanced glycation end products in the severity of SARS-CoV-2 infection in diabetic patients.Diabetology international · 2024Review
- Vitamin D and COVID-19: comparative analysis with other respiratory infections and impact of comorbidities.Germs · 2024Article
- Pre-hospital oxygen therapy and saturation variability in COVID-19 patients with and without glucose metabolism disorders: part of the COLOS Study.Scientific reports · 2024Article
- Long-Term Outcomes of COVID-19 in Hospitalized Type 2 Diabetes Mellitus Patients.Biomedicines · 2024Article
- Comparing adults with severe SARS-CoV-2 or influenza infection: South Africa, 2016-2021.Southern African journal of infectious diseases · 2024Article
- Metabolic Associated Fatty Liver Disease (MAFLD) and COVID-19 Infection: An Independent Predictor of Poor Disease Outcome?Medicina (Kaunas, Lithuania) · 2023Observational
- Atypical clinical features of post COVID-19 mucormycosis: A case series.Clinical and experimental dental research · 2023Article
- Insulin may increase disease severity and mortality of COVID-19 through NaJournal of endocrinological investigation · 2023Article
- Immunogenicity, safety and clinical outcomes of the SARS-CoV-2 BNT162b2 vaccine in adolescents with type 1 diabetes.Frontiers in pediatrics · 2023Article
- Myeloid-derived suppressor cells exacerbate poly(I:C)-induced lung inflammation in mice with renal injury and older mice.Frontiers in immunology · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.