COVID-19 AND DIABETES MELLITUS: METABOLIC, INFLAMMATORY AND OXIDATIVE REPERCUSSIONS

Abstract

Coronavirus disease (Covid-19) concomitant with diabetes is associated with greater severity and increased mortality. This review aims to understand the glycemic, inflammatory and oxidative repercussions involved in the interaction between Covid-19 and Diabetes mellitus. This is a narrative review based on searches in the PubMed database (Medline) using the keywords "Covid-19" and "Diabetes mellitus". Narrative and systematic reviews published in English between 2020 and 2022 were preferably included. Hyperglycemia was related to increased virus replication, intensification of the inflammatory process and presence of oxidative stress, contributing to immune dysfunction and changes in ACE2 receptors. The hypoglycemic agents metformin, glucagon-like peptide (GLP-1) receptor agonists and SGLT-2 inhibitors were associated with lower mortality rates. The inflammatory process and oxidative stress arise from mechanisms that include the impairment of counterregulatory pathways of inflammation; facilitation of virus entry and binding with receptor on the cell surface; overproduction of inflammatory cytokines; increased production of superoxide; increased production of nitric oxide; and release of free iron by the breakdown of hemoglobin. The use of antioxidants stands out as a promising treatment perspective.