Diabetes Mellitus and COVID-19: A Bad Prognosis Association

Short Communication

J Endocr Disord. 2020; 6(2): 1037.

Diabetes Mellitus and COVID-19: A Bad Prognosis Association

El Guendouz F¹*, Safi S²

¹Department of Endocrinology, Moulay Ismail Military Hospital of Meknes, Sidi Mohamed Ben Abdellah University Fes, Morocco

²Department of International Journal of Case Reports, University of Fes, Morocco

*Corresponding author: Faycal El Guendouz, Department of Endocrinology, Moulay Ismail Military Hospital of Meknes, Sidi Mohamed Ben Abdellah University Fes, Morocco

Received: May 29, 2020; Accepted: June 29, 2020; Published: July 06, 2020

Short Communication

Diabetes is a risk factor for bad prognosis of COVID-19. The high prevalence of diabetes on the African continent, particularly in North Africa (12.2%), constitutes a threat of increased morbidity and mortality linked to COVID-19. We must pay particular attention to this fragile population, with more time and resources, especially for the elderly, obese or those with chronic complications of diabetes who have a high risk of developing severe forms.

To the editors of the European Journal of Respiratory Medicine

New pneumonia caused by a new coronavirus named SARSCOV2 appeared in China at the end of 2019 and quickly spread around the world (it approaches 5 million cases in 188 countries at the time of writing of this letter). The case fatality rate varied so much internationally, In China it was between 1 and 2%, in Europe it was around 9% in some countries and in Africa it is 3.2%. This disparity in rates is explained by the quality of screening and the nature of the population. We have noticed in Morocco, that the lethality rate went from 7% in April to 2.7% in May, this decrease was proportional to the increase in the number of screening tests per day. In the literature, the most distinctive comobidities related to a poor prognosis of COVID-19 pneumonia are cardiovascular (hypertension and ischemic heart disease), metabolic (diabetes, obesity), chronic or respiratory renal diseases [1]. Table 1 summarizes the main comorbidities associated with COVID-19 infection in Italy [2] . Diabetes is one of the most common comorbidities in infected patients, the second in China and Italy after hypertension [2-4]. Data from China have reported an increased incidence of COVID-19 in diabetics [1,2]. However, a recent meta-analysis of 12 studies including a total of 2,108 Chinese patients concluded that diabetes paradoxically does not increase the risk of infection by the virus [5]. Regarding the impact of diabetes on the prognosis of the disease, only 6 of 12 Chinese studies have been able to provide information, and they confirmed that diabetes should be considered as a risk factor for a rapid progression and bad prognosis of COVID-19 [5]. Similarly, based on data from the Chinese center for disease control including more than 44,000 confirmed cases, the fatality rate was multiplied by 3 in the presence of diabetes (2.3% vs 7.3%) [5]. In virology, this finding is not new, it has already been reported for other respiratory viral infections including seasonal flu, influenza A (H1N1) in 2009 and the two previous COVID infections: SARS in 2002 and MERS in 2012 [6,7]. A recent French observational study was the first to focus on the predictors of severe forms in hospitalized diabetic patients; they were similar to those found in the non-diabetic population, such as age and obesity, but adding that the presence of complications of diabetes was positively associated with death. Insulin (the agent of choice to control sugars in hospitalised patients with COVID-19), like other antihypertensive medications that interact with the reninangiotensin- aldosterone system, is not a risk factor for severe form of COVID-19 [8].

Citation: El Guendouz F, Safi S. Diabetes Mellitus and COVID-19: A Bad Prognosis Association. J Endocr Disord. 2020; 6(2): 1037.