Plenary Conference: Epidemiology in the storm: diabetes in the COVID-19 crisis

Abstract

The COVID-19 (SARS-CoV-2) pandemic represents a considerable challenge to health systems and epidemiological predictions in the world. It is a viral infection caused by a positive single-stranded RNA agent that has a lipid envelope in which proteins with various biological functions are embedded (proteins S, M, E). The viral RNA codes for the synthesis of an RNA polymerase (RdRp) and two proteases (C3CLpro and PLpro). The virus causes damage through direct mechanisms (inducing pyroptosis in some tissues) and, partly as a consequence of them, a series of indirect immunoinflammatory phenomena with the participation of various cytokines and other immunomodulatory molecules, and diverse cellular responses. As a consequence, some patients experience a dysregulated inflammatory response, which appears to be related to severe disease and mortality. The presence of diabetes (at least type 2 diabetes mellitus -DM2-) seems to be associated with a greater risk of severe morbidity and mortality. It is not clear whether people with diabetes face an increased risk of infection, but the presence of T2DM is associated with an increased relative risk of developing severe disease, admission to intensive care units and/or death that ranges, in various studies, between 50% and 250% (OR: 1.50 to 3.5).