Highlights

• Hyperglycemia has been reported in almost half of the patients infected with coronavirus disease 2019.
• In critically ill patients, hyperglycemia is associated with increased morbidity and mortality, irrespective of preexisting diabetes.
• In our study, patients with blood glucose ≥140 mg/dL and admitted to the intensive care unit were found to have the worst outcomes in terms of mortality, mechanical ventilation need, and intensive care unit length of stay.
• Further studies are needed to clarify if outcomes significantly improve with tighter glucose targets.

Highlights

• The progression and outcome of coronavirus disease 2019 (COVID-19) may relate to diabetes; however, whether the diabetic treatment principles can be used for COVID-19 is unclear.
• Here, we screened all commonly used clinical oral hypoglycemic drugs to identify the potential inhibitors of M^pro and found six candidate drugs, including repaglinide, canagliflozin, glipizide, gliquidone, glimepiride, and linagliptin.
• The results indicated that these six antidiabetic drugs may have an extra effect on the treatment of COVID-19, although further preclinical experiment and clinical research are necessary to confirm these findings.

Highlights

• Fasting blood glucose < 10 mmol/L was proposed as a target of glycemic control during the first week of hospitalization in patients with preexisting diabetes.
• Poor HbA1c levels prior to coronavirus disease 2019 (COVID-19) might not be associated with severity among patients with preexisting diabetes.
• Mean blood glucose seemed not to be associated with poor prognosis of COVID-19.

Highlights

• Type 2 diabetes mellitus (T2DM) is associated with chronic inflammation due to underlying insulin resistance and other comorbidities including obesity, older age, hypertension, cardiovascular disease, and dyslipidemia.
• Insulin resistance, hyperglycemia, and elevated angiotensin-converting enzyme 2 (which acts as cellular “receptor” for the virus) leads to heightened inflammation in T2DM.
• We hypothesize that exacerbation of preexisting chronic inflammation and the intense hyperimmune response (“cytokine storm”) play a critical role in increased morbidity and mortality of coronavirus disease 2019 (COVID-19).
• Safe and rigorous blood glucose, blood pressure, and lipid control is recommended in patients with T2DM and COVID-19.

Highlights

• Type 2 diabetes mellitus (T2DM) patients with severe acute respiratory syndrome coronavirus 2 infection had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury. T2DM aggravated the clinical status of coronavirus disease 2019 (COVID-19) patients and increased their critical illness rate and mortality.
• Glucocorticoid treatment and poor fasting blood glucose (≥11.1 mmol/L) control were found to be risk factors of fatality in T2DM patients with severe COVID-19.

Highlights

• Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2; recent modeling of the structure of SARS-CoV-2 spike glycoprotein, which mediates viral-host-cell entry, predicts interactions with dipeptidyl peptidase 4 (DPP4) in addition to angiotensin-converting enzyme 2.
• Increased DPP4 expression and activity are associated with diabetes, obesity, and metabolic syndrome, all of which have been reported to influence COVID-19 severity.
• DPP4 inhibitors (gliptins), which vary in their interactions with the active site of the enzyme, may have immunomodulatory and cardioprotective effects that could be beneficial in COVID-19 cases.

Highlights

• Hydroxychloroquine (HCQ) has been shown to exert antihyperglycemic properties by virtue of potential multifaceted effects on glucose homeostasis, including improvement of insulin sensitivity, increase of insulin secretion, and reduction of systemic inflammation.
• Preliminary studies have shown the safety and efficacy of HCQ as an antihyperglycemic agent in type 2 diabetes over a short-term period.
• A careful risk-benefit assessment of HCQ is critical for a cautious use of this drug in diabetic patients, particularly in light of the current COVID-19 pandemic.