COVID-19 and metabolic disease: mechanisms and clinical management

Lancet Diabetes Endocrinol. 2021 Nov;9(11):786-798. doi: 10.1016/S2213-8587(21)00244-8. Epub 2021 Oct 4.

Abstract

Up to 50% of the people who have died from COVID-19 had metabolic and vascular disorders. Notably, there are many direct links between COVID-19 and the metabolic and endocrine systems. Thus, not only are patients with metabolic dysfunction (eg, obesity, hypertension, non-alcoholic fatty liver disease, and diabetes) at an increased risk of developing severe COVID-19 but also infection with SARS-CoV-2 might lead to new-onset diabetes or aggravation of pre-existing metabolic disorders. In this Review, we provide an update on the mechanisms of how metabolic and endocrine disorders might predispose patients to develop severe COVID-19. Additionally, we update the practical recommendations and management of patients with COVID-19 and post-pandemic. Furthermore, we summarise new treatment options for patients with both COVID-19 and diabetes, and highlight current challenges in clinical management.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • COVID-19 / epidemiology*
  • COVID-19 / metabolism*
  • COVID-19 / therapy
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / therapy
  • Disease Management*
  • Humans
  • Hypertension / epidemiology
  • Hypertension / metabolism
  • Hypertension / therapy
  • Metabolic Diseases / epidemiology*
  • Metabolic Diseases / metabolism*
  • Metabolic Diseases / therapy
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / metabolism
  • Non-alcoholic Fatty Liver Disease / therapy
  • Obesity / epidemiology
  • Obesity / metabolism
  • Obesity / therapy

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2