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Annales d'endocrinologie · Jun 2020
ReviewCOVID-19 in diabetic patients: Related risks and specifics of management.
- Laura Orioli, Michel P Hermans, Jean-Paul Thissen, Dominique Maiter, Bernard Vandeleene, and Jean-Cyr Yombi.
- Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Brussels, Belgium; Department of Endocrinology, Diabetology and Nutrition, IREC, UCLouvain, avenue Hippocrate 55, Brussels, Belgium. Electronic address: laura.orioli@uclouvain.be.
- Ann. Endocrinol. (Paris). 2020 Jun 1; 81 (2-3): 101-109.
AbstractDiabetes is among the most frequently reported comorbidities in patients infected with COVID-19. According to current data, diabetic patients do not appear to be at increased risk of contracting SARS-CoV-2 compared to the general population. On the other hand, diabetes is a risk factor for developing severe and critical forms of COVID-19, the latter requiring admission to an intensive care unit and/or use of invasive mechanical ventilation, with high mortality rates. The characteristics of diabetic patients at risk for developing severe and critical forms of COVID-19, as well as the prognostic impact of diabetes on the course of COVID-19, are under current investigation. Obesity, the main risk factor for incident type 2 diabetes, is more common in patients with critical forms of COVID-19 requiring invasive mechanical ventilation. On the other hand, COVID-19 is usually associated with poor glycemic control and a higher risk of ketoacidosis in diabetic patients. There are currently no recommendations in favour of discontinuing antihypertensive medications that interact with the renin-angiotensin-aldosterone system. Metformin and SGLT2 inhibitors should be discontinued in patients with severe forms of COVID-19 owing to the risks of lactic acidosis and ketoacidosis. Finally, we advise for systematic screening for (pre)diabetes in patients with proven COVID-19 infection.Copyright © 2020. Published by Elsevier Masson SAS.
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