COVID-19 and Diabetes: A Comprehensive Review of Angiotensin Converting Enzyme 2, Mutual Effects and Pharmacotherapy

Front Endocrinol (Lausanne). 2021 Nov 19:12:772865. doi: 10.3389/fendo.2021.772865. eCollection 2021.

Abstract

The potential relationship between diabetes and COVID-19 has been evaluated. However, new knowledge is rapidly emerging. In this study, we systematically reviewed the relationship between viral cell surface receptors (ACE2, AXL, CD147, DC-SIGN, L-SIGN and DPP4) and SARS-CoV-2 infection risk, and emphasized the implications of ACE2 on SARS-CoV-2 infection and COVID-19 pathogenesis. Besides, we updated on the two-way interactions between diabetes and COVID-19, as well as the treatment options for COVID-19 comorbid patients from the perspective of ACE2. The efficacies of various clinical chemotherapeutic options, including anti-diabetic drugs, renin-angiotensin-aldosterone system inhibitors, lipid-lowering drugs, anticoagulants, and glucocorticoids for COVID-19 positive diabetic patients were discussed. Moreover, we reviewed the significance of two different forms of ACE2 (mACE2 and sACE2) and gender on COVID-19 susceptibility and severity. This review summarizes COVID-19 pathophysiology and the best strategies for clinical management of diabetes patients with COVID-19.

Keywords: ACE2 (angiotensin converting enzyme 2); COVID - 19; SARS- CoV-2; diabetes mellitus; receptor; therapeutic management.

Publication types

  • Review

MeSH terms

  • Aged
  • Angiotensin-Converting Enzyme 2 / blood*
  • Animals
  • COVID-19 / complications*
  • COVID-19 Drug Treatment*
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / drug therapy
  • Comorbidity
  • Diabetes Complications / drug therapy*
  • Diabetes Mellitus / drug therapy*
  • Female
  • Humans
  • Hyperglycemia / metabolism
  • Hypertension
  • Inflammation
  • Insulin Resistance
  • Insulin-Secreting Cells / metabolism
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / drug therapy
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / drug therapy
  • Risk
  • Risk Factors
  • SARS-CoV-2

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2