Subject(s)
Blood Glucose/metabolism , Coronavirus Infections/therapy , Diabetes Mellitus, Type 2/therapy , Hospitalization , Insulin/administration & dosage , Peptidyl-Dipeptidase A/physiology , Pneumonia, Viral/therapy , Angiotensin-Converting Enzyme 2 , Animals , Blood Glucose/drug effects , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Drug Administration Schedule , Early Medical Intervention/methods , Early Medical Intervention/standards , Glycated Hemoglobin/drug effects , Glycated Hemoglobin/metabolism , Humans , Hypoglycemic Agents/administration & dosage , Mice , Mice, Knockout , Pandemics , Peptidyl-Dipeptidase A/therapeutic use , Peptidyl-Dipeptidase A/urine , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Recombinant Proteins/therapeutic use , Time FactorsABSTRACT
BACKGROUND: Diabetes mellitus is associated with a more severe course of coronavirus disease 2019 (COVID-19). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) utilizes angiotensin-converting enzyme II (ACE2) receptor for host cell entry. We aimed to assess the interactions between antihyperglycemic drugs and the renin-angiotensin system (RAS) and their putative roles in COVID-19. METHODS: A literature search was performed using Pubmed to review the interrelationships between hyperglycemia, RAS and COVID-19, and the effects of antihyperglycemic medications. RESULTS: The RAS has an essential role in glucose homeostasis and may have a role in COVID-19-induced lung injury. Some antihyperglycemic medications modulate RAS and might hypothetically alleviate the deleterious effect of angiotensin II on lung injury. Furthermore, most antihyperglycemic medications showed anti-inflammatory effects in animal models of lung injury. CONCLUSIONS: Some antihyperglycemic medications might have protective effects against COVID-19-induced lung injury. Early insulin therapy seems very promising in alleviating lung injury.