SARS‑CoV‑2 infection and diabetes mellitus: A North Eastern Romanian experience

Manciuc,Carmen; Nemescu,Dragos; Vata,Andrei; Lacatusu,Georgiana Alexandra

doi:10.3892/etm.2021.9710

SARS‑CoV‑2 infection and diabetes mellitus: A North Eastern Romanian experience

Authors:
- Carmen Manciuc
- Dragos Nemescu
- Andrei Vata
- Georgiana Alexandra Lacatusu
View Affiliations

Affiliations: Department of Infectious Diseases, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania, Department of Obstetrics and Gynecology, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania, Department of Infectious Diseases, ‘Sf. Parascheva’ Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
Published online on: January 25, 2021 https://doi.org/10.3892/etm.2021.9710
Article Number: 279

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

As it spread globally, the new SARS‑CoV‑2 virus was first confirmed in Romania in February 2020, inevitably infecting individuals with diabetes mellitus (DM) along the way. Diabetes is known to affect the response of the body to pathogens and, according to studies conducted in the last 3 months, it appears that diabetic patients are at a higher risk for developing severe forms of the disease and multiple complications. We performed a retrospective study in order to assess the patients with SARS‑CoV‑2 infection and DM admitted to ‘Sf. Parascheva’ Clinical Hospital of Infectious Diseases from March 4th until June 30th, 2020. Of the total 1,080 patients admitted during this period, 85 patients (7.87%) had underlying DM, mostly type 2 (82 cases, 96.46%); the mean age of these patients was 62, and 42 were men (49.41%). Chest CTs revealed indicative SARS‑CoV‑2 images for all patients and their treatment included individually tailored administration of hydroxychloroquine/lopinavir + ritonavir/enoxaparin sodium/tocilizumab/antibiotherapy according to the then national and international guidelines. In total, 70 patients (82.35%) were cured and 15 succumbed to MODS and/or associated neoplasia, bringing the fatality rate to 17.64%. Although advanced age and DM have been associated with aggravated forms of SARS‑CoV‑2 infection, over 80% of the patients included in the present study were cured. Nonetheless, diabetes appears to be a significant predictor of morbidity and mortality in the SARS‑CoV‑2 infection.

View Figures

View References

1	Coronavirus disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update. https://www.who.int/docs/default-source/coronaviruse/20200630-covid-19-sitrep-162.pdf?sfvrsn= e00a5466_2. Accessed June 30, 2020.
2	Cui J, Li F and Shi ZL: Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 17:181–192. 2019.PubMed/NCBI View Article : Google Scholar
3	Song Z, Xu Y, Bao L, Zhang L, Yu P, Qu Y, Zhu H, Zhao W, Han Y and Qin C: From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 11(59)2019.PubMed/NCBI View Article : Google Scholar
4	Docea AO, Tsatsakis A, Albulescu D, Cristea O, Zlatian O, Vinceti M, Moschos SA, Tsoukalas D, Goumenou M, Drakoulis N, et al: A new threat from an old enemy: Re-emergence of coronavirus (Review). Int J Mol Med. 45:1631–1643. 2020.PubMed/NCBI View Article : Google Scholar
5	Ceccarelli M, Berretta M, Venanzi Rullo E, Nunnari G and Cacopardo B: Differences and similarities between Severe Acute Respiratory Syndrome (SARS)-CoronaVirus (CoV) and SARS-CoV-2. Would a rose by another name smell as sweet? Eur Rev Med Pharmacol Sci. 24:2781–2783. 2020.PubMed/NCBI View Article : Google Scholar
6	Tanasa IA, Manciuc C, Carauleanu A, Navolan DB, Bohiltea RE and Nemescu D: Anosmia and ageusia associated with coronavirus infection (COVID-19)-what is known? Exp Ther Med. 20:2344–2347. 2020.PubMed/NCBI View Article : Google Scholar
7	Williams R, Karuranga S, Malanda B, Saeedi P, Basit A, Besançon S, Bommer C, Esteghamati A, Ogurtsova K, Zhang P and Colagiuri S: Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 162(108072)2020.PubMed/NCBI View Article : Google Scholar
8	Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, et al: China medical treatment expert group for Covid-19: Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 382:1708–1720. 2020.PubMed/NCBI View Article : Google Scholar
9	Wu Z and McGoogan JM: Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 323:1239–1242. 2020.
10	Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, Wu Y, Zhang L, Yu Z, Fang M, et al: Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 8:475–481. 2020.PubMed/NCBI View Article : Google Scholar
11	Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang L, Zhou X, Du C, et al: Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 180:934–943. 2020.PubMed/NCBI View Article : Google Scholar
12	Geerlings SE and Hoepelman AI: Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 26:259–265. 1999.PubMed/NCBI View Article : Google Scholar
13	Jafar N, Edriss H and Nugent K: The effect of short-term hyperglycemia on the innate immune system. Am J Med Sci. 351:201–211. 2016.PubMed/NCBI View Article : Google Scholar
14	Onder G, Rezza G and Brusaferro S: Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 323:1775–1776. 2020.PubMed/NCBI View Article : Google Scholar
15	Calina D, Docea AO, Petrakis D, Egorov AM, Ishmukhametov AA, Gabibov AG, Shtilman MI, Kostoff R, Carvalho F, Vinceti M, et al: Towards effective COVID-19 vaccines: Updates, perspectives and challenges (Review). Int J Mol Med. 46:3–16. 2020.PubMed/NCBI View Article : Google Scholar
16	Manciuc C and Largu A: Impact and risk of institutionalized environments on the psyho-emotional development of the HIV-positive youth. Environ Eng Manag J. 13:3123–3129. 2014.
17	Manciuc C, Filip-Ciubotaru F, Badescu A, Duceag LD and Largu AM: The patient-doctor-psychologist triangle in a case of severe imunosupression in the HIV infection. Rev Med Chir Soc Med Nat Iasi. 120:119–123. 2016.PubMed/NCBI
18	Centers for Disease Control and Prevention: National Diabetes Statistics Report, 2020. Centers for Disease Control and Prevention, US Department of Health and Human Services, Atlanta, GA, pp9, 2020.
19	Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, Ji R, Wang H, Wang Y and Zhou Y: Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis. Int J Infect Dis. 94:91–95. 2020.PubMed/NCBI View Article : Google Scholar
20	Emerging Risk Factors Collaboration. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, et al: Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of 102 prospective studies. Lancet. 375:2215–2222. 2010.PubMed/NCBI View Article : Google Scholar
21	Chentli F, Azzoug S and Mahgoun S: Diabetes mellitus in elderly. Indian J Endocrinol Metab. 19:744–752. 2015.PubMed/NCBI View Article : Google Scholar
22	Davis JW, Chung R and Juarez DT: Prevalence of comorbid conditions with aging among patients with diabetes and cardiovascular disease. Hawaii Med J. 70:209–213. 2011.PubMed/NCBI
23	Tyrovolas S, Koyanagi A, Garin N, Olaya B, Ayuso-Mateos JL, Miret M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S, Leonardi M, et al: Diabetes mellitus and its association with central obesity and disability among older adults: A global perspective. Exp Gerontol. 64:70–77. 2015.PubMed/NCBI View Article : Google Scholar
24	Hong KW, Cheong HJ, Choi WS, Lee J, Wie SH, Baek JH, Kim HY, Jeong HW and Kim WJ: Clinical courses and outcomes of hospitalized adult patients with seasonal influenza in Korea, 2011-2012: Hospital-based Influenza Morbidity & Mortality (HIMM) surveillance. J Infect Chemother. 20:9–14. 2014.PubMed/NCBI View Article : Google Scholar
25	Schoen K, Horvat N, Guerreiro NFC, de Castro I and de Giassi KS: Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 19(964)2019.PubMed/NCBI View Article : Google Scholar
26	Istituto Superiore di Sanita: Report of characteristics of patients died positive for COVID-19 in Italy. Accesed May 21, 2020.
27	Moutschen MP, Scheen AJ and Lefebvre PJ: Impaired immune responses in diabetes mellitus: Analysis of the factors and mechanisms involved. Relevance to the increased susceptibility of diabetic patients to specific infections. Diabete Metab. 18:187–201. 1992.PubMed/NCBI
28	Knapp S: Diabetes and infection: Is there a link?-A mini-review. Gerontology. 59:99–104. 2013.PubMed/NCBI View Article : Google Scholar
29	Reading PC, Allison J, Crouch EC and Anders EM: Increased susceptibility of diabetic mice to influenza virus infection: Compromise of collectin-mediated host defense of the lung by glucose? J Virol. 72:6884–6887. 1998.PubMed/NCBI View Article : Google Scholar
30	Ilyas R, Wallis R, Soilleux EJ, Townsend P, Zehnder D, Tan BK, Sim RB, Lehnert H, Randeva HS and Mitchell DA: High glucose disrupts oligosaccharide recognition function via competitive inhibition: A potential mechanism for immune dysregulation in diabetes mellitus. Immunobiology. 216:126–131. 2011.PubMed/NCBI View Article : Google Scholar
31	Kohio HP and Adamson AL: Glycolytic control of vacuolar-type ATPase activity: A mechanism to regulate influenza viral infection. Virology. 444:301–309. 2013.PubMed/NCBI View Article : Google Scholar
32	Dunn EJ and Grant PJ: Type 2 diabetes: An atherothrombotic syndrome. Curr Mol Med. 5:323–332. 2005.PubMed/NCBI View Article : Google Scholar
33	Lange P, Groth S, Kastrup J, Mortensen J, Appleyard M, Nyboe J, Jensen G and Schnohr P: Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study. Eur Respir J. 2:14–19. 1989.PubMed/NCBI
34	Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, et al: Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 395:507–513. 2020.PubMed/NCBI View Article : Google Scholar
35	Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, et al: Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ. 368(m1091)2020.PubMed/NCBI View Article : Google Scholar
36	Gao Y, Li T, Han M, Li X, Wu D, Xu Y, Zhu Y, Liu Y, Wang X and Wang L: Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 92:791–796. 2020.PubMed/NCBI View Article : Google Scholar
37	Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, Ye L, Xiong J, Jiang Z, Liu Y, et al: Prognostic value of C-reactive protein in patients with COVID-19. Clin Infect Dis: May 23, 2020 (Epub ahead of print). doi: 10.1093/cid/ciaa641.