Variation of the COVID-19 characteristics between genders

During the current COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), males have been observed to be more susceptible to severe or even fatal courses of COVID-19 compared to females, although infection rates are comparable. There is also evidence that women are at higher risk of developing long COVID syndrome. Here, we review how sex-specific differences in immune response, susceptibility to various comorbidities, SARS-CoV-2 entry pathways, and the endocrine stress axis might contribute to the variation of COVID-19 characteristics between both sexes. Behavioral and lifestyle factors are considered as well as the influence of sex hormones and sex chromosomes. A better understanding of the underlying immunologic, metabolic, and endocrine mechanisms that contribute to sexual dimorphism in COVID-19 could lead to sex-specific treatment strategies for severe COVID-19 courses and improve outcomes for these patients. © 2023 Elsevier Inc. All rights reserved.

Phase 1C study of the aldosterone synthase inhibitor BI 690517 in diabetic patients with kidney disease

Background: Preclinical studies showed aldosterone synthase inhibitors (ASis) to be beneficial in diabetic nephropathy. This placebo (PBO)-controlled, multiple dose, Phase Ic study (NCT03165240) assessed the safety and efficacy of the selective ASi BI 690517 in diabetic patients with kidney disease and albuminuria. Methods: Patients with type 1 or type 2 diabetes, estimated glomerular filtration rate (eGFR) 20-75 mL/min/1.73m2 and urine albumin creatinine ratio (UACR) 200-3500 mg/g, receiving stable angiotensin receptor blocker/angiotensin-converting enzyme inhibitor treatment were randomised to receive daily oral BI 690517 (3/10/40 mg), eplerenone (25-50 mg) or PBO for 28 days. Drug related adverse events (DRAEs) and seated systolic blood pressure (SBP) were recorded to assess safety. Efficacy was assessed by the proportion of responders, defined as patients with ≥20% decrease from baseline UACR (measured in first morning void [UACRFMV] and 10-h urine [UACR10h] [10/40 mg only]). Due to COVID-19, eplerenone and BI 690517 40 mg group enrolment were stopped early;BI 690517 doses were compared with matching PBO pooled from all dose groups. Results: IIn total, 58 patients (3 mg n=18;10 mg n=13;40 mg n=14;eplerenone n=4;PBO n=9) with median baseline UACR of 873.5 mg/g and eGFR of 41.0 mL/min/ 1.73m2 were treated. DRAEs occurred in 8 patients (14.8%), all receiving BI 690517;the most frequent were constipation and hyperkaliaemia (both 3.7%, n=2). Treatment was prematurely discontinued in 5 patients (9.3%: BI 690517 n=4;PBO n=1), 2 cases (3.7%) due to DRAEs. Changes seen in SBP did not differ between PBO and BI 685509 dose groups. Compared with PBO, the proportion of patients receiving BI 690517 classed as responders was higher for UACRFMV (PBO 37.5% vs 3 mg 61.1%;10 mg 53.8%;40 mg 80.0%) but similar for UACR10h (PBO 50.0% vs 10 mg 50.0%;40 mg 60.0%). Conclusions: BI 690517 was generally well tolerated and appears to have an early effect on UACR, with over 50% of treated patients being classed as responders. These data need to be confirmed in larger studies.

The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease.

Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.

Practical recommendations of the German Diabetes Society for the management of diabetes in patients with COVID-19

In subjects with an infection with the novel corona virus SARS-CoV-2 and COVID-19 disease, diabetes mellitus and cardiovascular diseases are highly prevalent comorbidities. Diabetes patients with comorbidities and/or diabetes complications seem to have a higher risk for a severe course of the COVID-19 disease including the development of ARDS or multiorgan failure. The exact interrelations between diabetes and the individual clinical course of COVID-19 are not completely understood at this time. The German Diabetes Association (DDG) summarizes basic principle practice recommendations for the treatment of patients with diabetes and concomitant COVID-19 disease. © 2021, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Practical Recommendations for diabetes management in patients with COVID-19 disease. [German]

In subjects with an infection with the novel corona virus SARS-CoV-2 and COVID-19 disease, diabetes mellitus and cardiovascular diseases are highly prevalent comorbidities. Diabetes patients with comorbidities and/or diabetes complications seem to have a higher risk for a severe course of the COVID-19 disease including the development of ARDS or multiorgan failure. The exact interrelations between diabetes and the individual clinical course of COVID-19 are not completely understood at this time. The German Diabetes Association (DDG) summarizes basic principle practice recommendations for the treatment of patients with diabetes and concomitant COVID-19 disease. Copyright © 2020 Georg Thieme Verlag KG, Stuttgart New York.