ABSTRACT
Although coronavirus disease (COVID-19) is primarily a respiratory disease, the kidney may be among the target organs of infection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Independently of baseline kidney function, acute kidney injury (AKI) is a common complication of COVID-19, associated with increased mortality and morbidity. Most frequently, COVID-19 causes acute tubular necrosis; however, in some cases, collapsing focal segmental glomerulosclerosis and direct viral tropism of the kidneys have also been documented. AKI secondary to COVID-19 has a multi-factorial origin. Even mild impairment of renal function is an independent risk factor for COVID-19 infection, hospitalisation and mortality. Dialysis patients also carry an increased risk of other severe COVID-related complications, including arrhythmias, shock, acute respiratory distress syndrome and acute heart failure. In such patients, COVID-19 may even present with atypical clinical symptoms, including gastrointestinal disorders and deterioration of mental status. More research is needed on the exact effects of SARS-CoV-2 on the kidneys. Finally, it remains to be proven whether the outcome of patients with kidney disease may be improved with anticipated vaccination programmes.
Subject(s)
Acute Kidney Injury , COVID-19 , Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , COVID-19/complications , Humans , Kidney , SARS-CoV-2ABSTRACT
Metformin remains the cornerstone of management for type 2 diabetes mellitus (T2DM). It is also known that it has beneficial pleiotropic actions. In addition, there is emerging evidence that this agent may prove beneficial in ameliorating depression in T2DM. The underlying mechanisms of this new action remain elusive, but experimental studies point to improved synaptic function and increased serotonin activity, along with the known inflammatory and antioxidant properties of metformin. Obviously, we need to further explore the potential utility of such antidepressant effects among T2DM subjects in everyday reality.
ABSTRACT
There is increasing evidence that coronavirus disease 2019 (COVID-19) may lead to new-onset diabetes mellitus (DM). This may occur even in patients without predisposing factors for impaired glucose metabolism. Both impaired pancreatic insulin secretion and insulin resistance have been implicated as underlying mechanisms. Importantly, new-onset hyperglycaemia is associated with worse prognosis in patients with COVID-19. Indeed, its prognosis may be even more sinister than in patients with pre-existing DM. More research data and knowledge are currently being collected to improve our insights into this constellation and to guide therapies in clinical reality.
ABSTRACT
Novel coronavirus infectious disease (COVID-19) has been recognised as a pandemic by the World Health Organization (WHO) 1. Mortality and morbidity are higher in elderly individuals and those with comorbidities, such as diabetes mellitus (DM), obesity, hypertension, respiratory tract diseases, coronary heart disease or cancer 1. Indeed, two thirds of individuals who died from COVID-19 had DM in Italy 2.
Subject(s)
COVID-19 , Communicable Diseases , Diabetes Mellitus, Type 2 , Sodium-Glucose Transporter 2 Inhibitors , Aged , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/epidemiology , Glucose , Humans , Sodium , Sodium-Glucose Transporter 2 Inhibitors/pharmacologyABSTRACT
Corona virus infectious disease (COVID-19) is a new pandemic. In subjects with diabetes mellitus, infection may be more frequent and severe. We discuss the potential contribution of two traditional oral antidiabetic agents, metformin and pioglitazone, to the improvement of liver injury in COVID-19. Clearly, further experience is needed to shed light on these hypotheses.