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Issues of Cardiovascular Risk Management in People With Diabetes in the COVID-19 Era.
Ceriello, Antonio; Standl, Eberhard; Catrinoiu, Doina; Itzhak, Baruch; Lalic, Nebojsa M; Rahelic, Dario; Schnell, Oliver; Skrha, Jan; Valensi, Paul.
  • Ceriello A; IRCCS MultiMedica, Milan, Italy antonio.ceriello@hotmail.it.
  • Standl E; Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.
  • Catrinoiu D; Clinical Center of Diabetes, Nutrition and Metabolic Diseases, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania.
  • Itzhak B; Clalit Health Services and Technion Faculty of Medicine, Haifa, Israel.
  • Lalic NM; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Rahelic D; Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia.
  • Schnell O; University of Zagreb School of Medicine, Zagreb, Croatia.
  • Skrha J; University of Osijek School of Medicine, Osijek, Croatia.
  • Valensi P; Forschergruppe Diabetes e.V. at Munich Helmholtz Centre, Munich, Germany.
Diabetes Care ; 43(7): 1427-1432, 2020 07.
Article in English | MEDLINE | ID: covidwho-360923
Semantic information from SemMedBD (by NLM)
1. Diabetes PROCESS_OF Persons
Subject
Diabetes
Predicate
PROCESS_OF
Object
Persons
2. Problem PROCESS_OF Persons
Subject
Problem
Predicate
PROCESS_OF
Object
Persons
3. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
4. COVID-19 AFFECTS Persons
Subject
COVID-19
Predicate
AFFECTS
Object
Persons
5. 2019 novel coronavirus CAUSES Cardiac Arrhythmia
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Cardiac Arrhythmia
6. 2019 novel coronavirus CAUSES Heart failure
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Heart failure
7. 2019 novel coronavirus CAUSES Myocardial Infarction
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Myocardial Infarction
8. 2019 novel coronavirus CAUSES Myocarditis
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Myocarditis
9. Severe Acute Respiratory Syndrome PROCESS_OF Persons
Subject
Severe Acute Respiratory Syndrome
Predicate
PROCESS_OF
Object
Persons
10. Diabetes PROCESS_OF Persons
Subject
Diabetes
Predicate
PROCESS_OF
Object
Persons
11. Problem PROCESS_OF Persons
Subject
Problem
Predicate
PROCESS_OF
Object
Persons
12. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
13. COVID-19 AFFECTS Persons
Subject
COVID-19
Predicate
AFFECTS
Object
Persons
14. 2019 novel coronavirus CAUSES Cardiac Arrhythmia
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Cardiac Arrhythmia
15. 2019 novel coronavirus CAUSES Heart failure
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Heart failure
16. 2019 novel coronavirus CAUSES Myocardial Infarction
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Myocardial Infarction
17. 2019 novel coronavirus CAUSES Myocarditis
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
Myocarditis
18. Severe Acute Respiratory Syndrome PROCESS_OF Persons
Subject
Severe Acute Respiratory Syndrome
Predicate
PROCESS_OF
Object
Persons
ABSTRACT
People with diabetes compared with people without exhibit worse prognosis if affected by coronavirus disease 2019 (COVID-19) induced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), particularly when compromising metabolic control and concomitant cardiovascular disorders are present. This Perspective seeks to explore newly occurring cardio-renal-pulmonary organ damage induced or aggravated by the disease process of COVID-19 and its implications for the cardiovascular risk management of people with diabetes, especially taking into account potential interactions with mechanisms of cellular intrusion of SARS-CoV-2. Severe infection with SARS-CoV-2 can precipitate myocardial infarction, myocarditis, heart failure, and arrhythmias as well as an acute respiratory distress syndrome and renal failure. They may evolve along with multiorgan failure directly due to SARS-CoV-2-infected endothelial cells and resulting endotheliitis. This complex pathology may bear challenges for the use of most diabetes medications in terms of emerging contraindications that need close monitoring of all people with diabetes diagnosed with SARS-CoV-2 infection. Whenever possible, continuous glucose monitoring should be implemented to ensure stable metabolic compensation. Patients in the intensive care unit requiring therapy for glycemic control should be handled solely by intravenous insulin using exact dosing with a perfusion device. Although not only ACE inhibitors and angiotensin 2 receptor blockers but also SGLT2 inhibitors, GLP-1 receptor agonists, pioglitazone, and probably insulin seem to increase the number of ACE2 receptors on the cells utilized by SARS-CoV-2 for penetration, no evidence presently exists that shows this might be harmful in terms of acquiring or worsening COVID-19. In conclusion, COVID-19 and related cardio-renal-pulmonary damage can profoundly affect cardiovascular risk management of people with diabetes.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Diabetes Mellitus / Betacoronavirus Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Diabetes Care Year: 2020 Document Type: Article Affiliation country: Dc20-0941

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Diabetes Mellitus / Betacoronavirus Type of study: Etiology study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Diabetes Care Year: 2020 Document Type: Article Affiliation country: Dc20-0941