COVID-19: Effects in Comorbidities and Special Populations

Diabetes Mellitus and COVID-19

Author(s): Sanjay Kumar Bhadada* and Rimesh Pal

Pp: 29-50 (22)

DOI: 10.2174/9789815036367122010004

* (Excluding Mailing and Handling)

Abstract

The novel coronavirus disease (COVID-19) has scourged the world since its outbreak in December 2019 in Wuhan, China. The disease tends to be asymptomatic or mild in nearly 80% of the patients. However, around 5% of the patients tend to have critical diseases complicated by acute respiratory distress syndrome (ARDS), shock, and multiple organ failure. The disease tends to be specifically severe in patients with advancing age and in those with underlying comorbidities. Diabetes mellitus has emerged as distinctive comorbidity that is associated with severe disease, acute respiratory distress syndrome, intensive care unit admission, and mortality in COVID- 19. The impaired innate immune system, underlying pro-inflammatory milieu, reduced expression of angiotensin-converting enzyme 2 (ACE2), and concomitant use of reninangiotensin- aldosterone system-active drugs are some of the proposed pathophysiological links between diabetes mellitus and COVID-19 severity. On the contrary, the presence of active COVID-19 infection in a patient with underlying diabetes mellitus leads to the worsening of glucose control. Although glucose control prior to hospital admission has not been consistently associated with clinical outcomes in diabetic patients with COVID-19, in-hospital good glycemic control is associated with a lower rate of complications and all-cause mortality.


Keywords: ACE2, ARDS, Case-fatality rate, Comorbidities, COVID-19, Cytokine storm, Diabetes mellitus, D-dimer, Glycemic control, Hypertension, HbA1c, IL-6, Mortality, Mortality rate, Novel coronavirus disease, Old age, SARS-CoV-2, Shock, T1D, T2D, Thromboembolism.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316204442 and j.to_ip >=316204442 )) and ((j.from_date <= 1739847466 and j.to_date >= 1739847466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17604) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316204442 and j.to_ip >=316204442 )) and ((j.from_date <= 1739847466 and j.to_date >= 1739847466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17604) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316204442 and j.to_ip >=316204442 )) and ((j.from_date <= 1739847466 and j.to_date >= 1739847466 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 17604)
      600μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 3392 and `b`.`banner_from_date` <= 1739847466 and `b`.`banner_to_date` >= 1739847466 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.06msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 3392
      • 3: 1739847466
      • 4: 1739847466
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='f0a4accb41944a21cbbcf0374b98ccc5'
      270μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    21Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        miGhVF13eQnUuXliOl0UnealXhWssNuKXchjBkbu
        uc_cart_id
        f0a4accb41944a21cbbcf0374b98ccc5
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17604" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/17604
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6InBGMUlHVDVncXo5czBJRE1jOU1NVFE9PSIsInZhbHVlIjoiU1J5Yk1GcXdZamx3bU9SdHp4ektjcEg1a0ZEYWV5cUhYektlRG95MVAvUT0iLCJtYWMiOiIzOWMwYjJmNzEwMTBjODBiM2ZjNTFjODg2OGJiMjYzYzZiYTE5OGU0ZjYzYzI0YTg4MDE5NGYwMmFhZmYzNjMxIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6InBGMUlHVDVncXo5czBJRE1jOU1NVFE9PSIsInZhbHVlIjoiU1J5Yk1GcXdZamx3bU9SdHp4ektjcEg1a0ZEYWV5cUhYektlRG95MVAvUT0iLCJtYWMiOiIzOWMwYjJmNzEwMTBj" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 18 Feb 2025 02:57:46 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IjkyTVE5cDFRbGV4MFF4QnZ4UW1wY3c9PSIsInZhbHVlIjoiM2tua3BqOVV6RnhuM2dNMDI3ZUp4UEN3ckUxOHRrNHN0djhhbjF5RlJRNitFMnlSQTJ4elUvblFYSzlETDFnM2tpVWFaM0FKbGM1TDBtZW12R2NlWVZQNlFRbUhkL3ZPM2JLY0V3OG1HQWFNVjBhaGJOWDhsWVYyR3JZZ3FTK3MiLCJtYWMiOiI5NjQ3ODdlYjE2YmRjYjBkMDI3NGY5NDIwOTNlMjI1MjliOGUxNWY3NGZkNjcyZGQyZGFjYWFlZTY3NjNkODdlIiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 14:57:46 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IjkyTVE5cDFRbGV4MFF4QnZ4UW1wY3c9PSIsInZhbHVlIjoiM2tua3BqOVV6RnhuM2dNMDI3ZUp4UEN3ckUxOHRrNHN0djhhbjF5RlJRNitFMnlSQTJ4elUvblFYSzlETDFnM2tpVWFaM" 1 => "alphaeurekaselectnet_session=eyJpdiI6InZIUlV0MW9oOSt6S3BpQmtHb1dTSVE9PSIsInZhbHVlIjoiNFc3ZmVmNlRtZkw2aEFsZm1OYWVBZ1MyUHNjaWJpNWE2Sk1JQ1VuNHVqOVBMR2I4c2kzbXNWaVcyWmY4emkxOFduRGp3VkN2OE9QVXQrZzl2aVJPTXpIc2xoT1Rybmg4STBmb0xGV0hVM2VRSlUyUUFjZWdRVGE1V01JSCtFT00iLCJtYWMiOiJjMGUxNzU3M2IzYmU1MDYxZmRlOTZhNTFhODk0NjVlMTM3MWNkNDA0N2VlNGQyMDI4MTkyZjg0NmNjZGM4NTc1IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6InZIUlV0MW9oOSt6S3BpQmtHb1dTSVE9PSIsInZhbHVlIjoiNFc3ZmVmNlRtZkw2aEFsZm1OYWVBZ1MyUHNjaWJpNWE2Sk1JQ1VuNHVqOVBMR2I4c2kzbXNWaVc" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IjkyTVE5cDFRbGV4MFF4QnZ4UW1wY3c9PSIsInZhbHVlIjoiM2tua3BqOVV6RnhuM2dNMDI3ZUp4UEN3ckUxOHRrNHN0djhhbjF5RlJRNitFMnlSQTJ4elUvblFYSzlETDFnM2tpVWFaM0FKbGM1TDBtZW12R2NlWVZQNlFRbUhkL3ZPM2JLY0V3OG1HQWFNVjBhaGJOWDhsWVYyR3JZZ3FTK3MiLCJtYWMiOiI5NjQ3ODdlYjE2YmRjYjBkMDI3NGY5NDIwOTNlMjI1MjliOGUxNWY3NGZkNjcyZGQyZGFjYWFlZTY3NjNkODdlIiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 14:57:46 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IjkyTVE5cDFRbGV4MFF4QnZ4UW1wY3c9PSIsInZhbHVlIjoiM2tua3BqOVV6RnhuM2dNMDI3ZUp4UEN3ckUxOHRrNHN0djhhbjF5RlJRNitFMnlSQTJ4elUvblFYSzlETDFnM2tpVWFaM" 1 => "alphaeurekaselectnet_session=eyJpdiI6InZIUlV0MW9oOSt6S3BpQmtHb1dTSVE9PSIsInZhbHVlIjoiNFc3ZmVmNlRtZkw2aEFsZm1OYWVBZ1MyUHNjaWJpNWE2Sk1JQ1VuNHVqOVBMR2I4c2kzbXNWaVcyWmY4emkxOFduRGp3VkN2OE9QVXQrZzl2aVJPTXpIc2xoT1Rybmg4STBmb0xGV0hVM2VRSlUyUUFjZWdRVGE1V01JSCtFT00iLCJtYWMiOiJjMGUxNzU3M2IzYmU1MDYxZmRlOTZhNTFhODk0NjVlMTM3MWNkNDA0N2VlNGQyMDI4MTkyZjg0NmNjZGM4NTc1IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6InZIUlV0MW9oOSt6S3BpQmtHb1dTSVE9PSIsInZhbHVlIjoiNFc3ZmVmNlRtZkw2aEFsZm1OYWVBZ1MyUHNjaWJpNWE2Sk1JQ1VuNHVqOVBMR2I4c2kzbXNWaVc" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "miGhVF13eQnUuXliOl0UnealXhWssNuKXchjBkbu" "uc_cart_id" => "f0a4accb41944a21cbbcf0374b98ccc5" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/17604" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-18 02:57:46GET/chapter/176041121923