Diabetics belong to one of the risk groups for COVID-19 disease. Chinese scientists have tried to find out the reasons for this in a recent series of cases involving non-diabetics and diabetics. But Italian scientists from Rome have also done research on this connection. The Chinese have investigated 237 non-diabetics and 37 diabetics. It is not possible to make generally valid statements, as comorbidities, the age of the patients and the small selection of patients in the small subgroups also had to be taken into account. However, it can be stated that certain trends are emerging. For example, fever is not as frequent in patients with diabetes as in patients without diabetes. The ratio here is 59.5 percent to 83.2 percent. Symptoms such as chills, coughing, breathlessness and tightness in the chest are also much less common in diabetics, so that the Italian researchers from Rome, Dr. Ernesto Maddaloni and Raffaella Buzzetti, also suspect a connection. The team of researchers led by Weina Guo from Wuhan at Huazhong University of Science and Technology, therefore, suspects, like the Italian experts, that COVID-19 is an underestimated risk in diabetics because hidden and so-called silent disease symptoms are usually more likely to appear. However, rapid action would be the top priority for diabetics. The studies also showed that patients with corona infection would have a worse blood sugar level if they were admitted to the hospital, which would have a negative effect on the course of the disease. The Chinese researchers‘ third observation is that SARS-CoV-2 could destroy pancreatic islet cells, especially in type 2 diabetics. An old study on the SARS virus from the past showed that 20 out of 39 patients in hospitals developed type 2 diabetes, some of which persisted later. This is because, in contrast to type 1 diabetes, the beta cells in the pancreas can still produce insulin, but then cease to function. However, scientific evidence has shown that the virus can damage insulin-producing beta cells. Scientists from New York also made similar observations in acute patients in the clinic. It was also observed that inflammation markers were elevated in diabetics, including interleukin-6, a pro-inflammatory cytokine, which was present at 13.73 pg/ml compared to 4.13 pg/ml for non-sugar patients. This fact strengthens the Italian scientists‘ belief that active ingredients from the group of monoclonal antibodies such as tocilizumab, sarilumab and siltuximab could be used as anti-inflammatory agents and interleukin-6 antibodies to help diabetics fight the coronavirus. The same applies to Janus kinase inhibitors, which also have an anti-inflammatory and selective immunomodulating effect and are otherwise taken, for example, in inflammatory bowel diseases and psoriasis-arthritis. However, further evidence-based studies must provide more clarity.
