COVID-19 e diabetes mellitus: uma revisão sistemática acerca de complicações, marcadores inflamatórios e mortalidade
DOI:
https://doi.org/10.60104/revhugv10021Palavras-chave:
COVID-19; Diabetes; Inflamação; Complicações.Resumo
A COVID-19 acomete principalmente indivíduos que apresentam comorbidades pré-existentes, dentre elas o Diabetes Mellitus (DM). Essa revisão sistemática objetivou estudar as relações entre COVID-19, DM, inflamação, complicações e desfechos. Realizou-se busca nas bases de dados MEDLINE e SCOPUS, até 05/05/2021. Selecionaram-se estudos observacionais contendo: pacientes de ambos os sexos com diagnósticos de DM e de COVID-19 e descrição de provas inflamatórias. Incluíram-se 35 estudos. Os participantes com DM apresentaram maiores níveis de marcadores inflamatórios, maior prevalência comorbidades cardiometabólicas e tendência a idade mais avançada quando comparados àqueles sem DM, o que se associou a proporções significativamente maiores de complicações da COVID-19, de comorbidades, de admissão em UTI, de duração de estadia hospitalar e de mortalidade na amostra. Conclui-se que os marcadores inflamatórios possuem valor preditor negativo no prognóstico dos pacientes que possuem COVID-19 concomitantemente com DM e que possivelmente refletem a sobreposição de mecanismos fisiopatológicos das duas doenças.
Referências
ALGUWAIHES, A. M.; AL-SOFIANI, M. E.; MEGDAD, M.; ALBADER, S. S. et al. Diabetes and Covid-19 among hospitalized patients in Saudi Arabia: a single-centre retrospective study. Cardiovascular DIabetology, 19, n. 1, 2020. Disponível em: https://doi.org/10.1186/s12933-020-01184-4
ALSHUKRY, A.; BU ABBAS, M.; ALI, Y.; ALAHMAD, B. et al. Clinical characteristics and outcomes of COVID-19 patients with diabetes mellitus in Kuwait. Heliyon, 7, n. 4, p. e06706, Apr 2021. Disponível em: https://doi.org/10.1371/journal.pone.0242768
BANSAL, R.; GUBBI, S.; MUNIYAPPA, R. Metabolic Syndrome and COVID 19: Endocrine-Immune-Vascular Interactions Shapes Clinical Course. Endocrinology, Jun 30 2020. Disponível em: https://doi.org/10.1210/endocr/bqaa112
BHANDARI, S.; SHAKTAWAT, A. S.; TAK, A.; SHUKLA, J. et al. Evaluating interactions between hyperglycemia and clotting factors in patients suffering with SARS-CoV-2 infection. Clinical Diabetology, 10, n.1 , p. 114-122, 2021. Disponível em: https://doi.org/10.5603/DK.A2021.0022
CHEN, Y.; YANG, D.; CHENG, B.; CHEN, J. et al. Clinical Characteristics and Outcomes of Patients with Diabetes and COVID-19 in Association with Glucose-Lowering Medication. Diabetes Care, 43, n. 7, 2020. Article. Disponível em: https://doi.org/10.2337/dc20-0660
CHENG, Y.; YUE, L.; WANG, Z.; ZHANG, J. et al. Hyperglycemia associated with lymphopenia and disease severity of COVID-19 in type 2 diabetes mellitus. Journal of Diabetes and its Complications, 35, n. 2, 2021. Disponível em: https://doi.org/10.1016/j.jdiacomp.2020.107809
CHUNG, S. M.; LEE, Y. Y.; HA, E.; YOON, J. S. et al. The Risk of Diabetes on Clinical Outcomes in Patients with Coronavirus Disease 2019: A Retrospective Cohort Study. Diabetes Metab J, 44, n. 3, p. 405-413, Jun 2020. Disponível em: https://doi.org/10.4093/dmj.2020.0105
CIARDULLO, S.; ZERBINI, F.; PERRA, S.; MURACA, E. et al. Impact of diabetes on COVID-19-related in-hospital mortality: a retrospective study from Northern Italy. Journal of Endocrinological Investigation, 44, n.4, p. 843-850, 2021. Disponível em: https://doi.org/10.1007/s40618-020-01382-7
CORRÊA, R. A.; COSTA, A. N.; LUNDGREN, F.; MICHELIN, L. et al. 2018 recommendations for the management of community acquired pneumonia. J Bras Pneumol, 44, n. 5, p. 405-423, 2018 Sep-Oct 2018. Disponível em: https://doi.org/10.1590/S1806-37562018000000130
DRUCKER, D. J. Coronavirus Infections and Type 2 Diabetes-Shared Pathways with Therapeutic Implications. Endocr Rev, 41, n. 3, Jun 1 2020. Disponível em: https://doi.org/10.1210/endrev/bnaa011
ELAMARI, S.; MOTAIB, I.; ZBIRI, S.; ELAIDAOUI, K. et al. Characteristics and outcomes of diabetic patients infected by the SARS-CoV-2. In: Pan Afr Med J: Copyright: Saloua Elamari et al., 2020. v. 37, p. 32. Disponível em: https://doi.org/10.11604/pamj.2020.37.32.25192
FADINI, G. P.; MORIERI, M. L.; BOSCARI, F.; FIORETTO, P. et al. Newly-diagnosed diabetes and admission hyperglycemia predict COVID-19 severity by aggravating respiratory deterioration. Diabetes Research and Clinical Practice, 2020. Article. Disponível em: https://doi.org/10.1016/j.diabres.2020.108374
FAN, E.; BRODIE, D.; SLUTSKY, A. S. Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment. JAMA, 319, n. 7, p. 698-710, 02 2018. Disponível em: https://doi.org/10.1001/jama.2017.21907
GONÇALVES, S. E. A. B.; GONÇALVES, T. J. M.; GUARNIERI, A.; RISEGATO, R. C. et al. Association between thiamine deficiency and hyperlactatemia among critically ill patients with diabetes infected by SARS-CoV-2. Journal of Diabetes, 13, n. 5, p. 413-419, 2021. Article. Disponível em: https://doi.org/10.1111/1753-0407.13156
GUO, W.; LI, M.; DONG, Y.; ZHOU, H. et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev, p. e3319, Mar 31 2020. Disponível em: https://doi.org/10.1002/dmrr.3319
HAN, M.; MA, K.; WANG, X.; YAN, W. et al. Immunological Characteristics in Type 2 Diabetes Mellitus Among COVID-19 Patients. Frontiers in Endocrinology, Mar 2021. Article. Disponível em: https://doi.org/10.3389/fendo.2021.596518
HUANG, J.; ZHU, L.; BAI, X.; JIA, X. et al. Multidimensional Analysis of Risk Factors for the Severity and Mortality of Patients with COVID-19 and Diabetes. Infectious Diseases and Therapy, 9, n.4, p. 981-1002, Dec 2020. Disponível em: https://doi.org/10.1007/s40121-020-00359-6
HUSSAIN, A.; BHOWMIK, B.; DO VALE MOREIRA, N. C. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract, 162, p. 108142, Apr 2020. Disponível em: https://doi.org/10.1016/j.diabres.2020.108142
JIN, Y.; YANG, H.; JI, W.; WU, W. et al. Virology, Epidemiology, Pathogenesis, and Control of COVID-19. Viruses, 12, n. 4, 03 2020. Disponível em: https://doi.org/10.3390/v12040372
KHALILI, S.; MORADI, O.; KHARAZMI, A. B.; RAOUFI, M. et al. Comparison of Mortality Rate and Severity of Pulmonary Involvement in Coronavirus Disease-2019 Adults Patients With and Without Type 2 Diabetes: A Cohort Study. Canadian Journal of Diabetes, 45, n. 6, p. 524-530, Aug 2021. Disponível em: https://doi.org/10.1016/j.jcjd.2020.10.014
KOH, H.; MOH, A. M. C.; YEOH, E.; LIN, Y. et al. Diabetes predicts severity of COVID-19 infection in a retrospective cohort: A mediatory role of the inflammatory biomarker C-reactive protein. J Med Virol, 93, n. 5, p. 3023-3032, May 2021. Disponível em: https://doi.org/10.1002/jmv.26837
LAMPASONA, V.; SECCHI, M.; SCAVINI, M.; BAZZIGALUPPI, E. et al. Antibody response to multiple antigens of SARS-CoV-2 in patients with diabetes: an observational cohort study. Diabetologia, 63, n. 12, Dec 2020. Disponível em: https://doi.org/10.1007/s00125-020-05284-4
LEI, M.; LIN, K.; PI, Y.; HUANG, X. et al. Clinical Features and Risk Factors of ICU Admission for COVID-19 Patients with Diabetes. Journal of Diabetes Research, 2020. Disponível em: https://doi.org/10.1155/2020/5237840
LI, B.; YANG, J.; ZHAO, F.; ZHI, L. et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol, 109, n. 5, p. 531-538, May 2020. Disponível em: https://doi.org/10.1007/s00392-020-01626-9
LIU, G.; ZHANG, S.; HU, H.; LIU, T. et al. The role of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio in the prognosis of type 2 diabetics with COVID-19. Scott Med J, 65, n. 4, p. 154-160, Nov 2020. Disponível em: https://doi.org/10.1177/0036933020953516
LIU, L.; WEI, W.; YANG, K.; LI, S. et al. Glycemic control before admission is an important determinant of prognosis in patients with coronavirus disease 2019. J Diabetes Investig, Oct 9 2020. Disponível em: https://doi.org/10.1111/jdi.13431
MADDALONI, E.; D'ONOFRIO, L.; ALESSANDRI, F.; MIGNOGNA, C. et al. Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: A multicentre retrospective study (CoViDiab II). Cardiovascular Diabetology, 2020. Disponível em: https://doi.org/10.1186/s12933-020-01140-2
MISHRA, Y.; PATHAK, B. K.; MOHAKUDA, S. S.; TILAK, T. V. S. V. G. K. et al. Relation of D-dimer levels of COVID-19 patients with diabetes mellitus. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 14, n. 6, pg. 1927-1930, Nov 2020. Disponível em: https://doi.org/10.1016/j.dsx.2020.09.035
MITHAL, A.; JEVALIKAR, G.; SHARMA, R.; SINGH, A. et al. High prevalence of diabetes and other comorbidities in hospitalized patients with COVID-19 in Delhi, India, and their association with outcomes. Diabetes Metab Syndr, 15, n. 1, p. 169-175, Jan-Feb 2021. Disponível em: https://doi.org/10.1016/j.dsx.2020.12.029
MOGHADDAM TABRIZI, F.; RASMI, Y.; HOSSEINZADEH, E.; REZAEI, S. et al. Diabetes is associated with higher mortality and severity in hospitalized patients with COVID-19. Excli j, 20, p. 444-453, 2021. Disponível em: https://doi.org/10.17179/excli2021-3403
MOSTAGHIM, A.; SINHA, P.; BIELICK, C.; KNUDSEN, S. et al. Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital. PLoS One, 15, n. 12, p. e0243888, 2020. Disponível em: https://doi.org/10.1371/journal.pone.0243888
PAL, R.; BHADADA, S. K. COVID-19 and diabetes mellitus: An unholy interaction of two pandemics. Diabetes Metab Syndr, 14, n. 4, p. 513-517, May 2020. Disponível em: https://doi.org/10.1016/j.dsx.2020.04.049
SOLIMAN, A.; NAIR, A. P.; AL MASALAMANI, M. S.; DE SANCTIS, V. et al. Prevalence, clinical manifestations, and biochemical data of type 2 diabetes mellitus versus nondiabetic symptomatic patients with COVID-19: A comparative study. Acta Biomedica, 14, n. 3, p. 1-9, Sep 2020. Disponível em: https://doi.org/10.23750/abm.v91i3.10214
SUN, Y.; ZHAO, R.; HU, Z.; WANG, W. et al. Differences in the Clinical and Hematological Characteristics of COVID-19 Patients with and without Type 2 Diabetes. J Diabetes Res, 2020, p. 1038585, 2020. Disponível em: https://doi.org/10.1155/2020/1038585
TADIC, M.; CUSPIDI, C.; SALA, C. COVID-19 and diabetes: Is there enough evidence? J Clin Hypertens (Greenwich), May 2020. Disponível em: https://doi.org/10.1111/jch.13912
VARGAS-VÁZQUEZ, A.; BELLO-CHAVOLLA, O. Y.; ORTIZ-BRIZUELA, E.; CAMPOS-MUÑOZ, A. et al. Impact of undiagnosed type 2 diabetes and pre-diabetes on severity and mortality for SARS-CoV-2 infection. BMJ Open Diabetes Research and Care, vol 9, issue 1, Feb 2021. Article number e002026. Disponível em: https://doi.org/10.1136/bmjdrc-2020-002026
WANG, D.; HU, B.; HU, C.; ZHU, F. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, Feb 2020. Disponível em: https://doi.org/10.1001/jama.2020.1585
WANG, X.; LIU, Z.; LI, J.; ZHANG, J. et al. Impacts of Type 2 diabetes on disease severity, therapeutic effect, and mortality of patients with COVID-19. J Clin Endocrinol Metab, Dec 2020. Disponível em: https://doi.org/10.1210/clinem/dgaa535
WANG, Z.; DU, Z.; ZHU, F. Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients. Diabetes Res Clin Pract, 164, p. 108214, Jun 2020. Disponível em: https://doi.org/10.1016/j.diabres.2020.108214
XU, Z.; WANG, Z.; WANG, S.; YE, Y. et al. The impact of type 2 diabetes and its management on the prognosis of patients with severe COVID-19. J Diabetes, Jul 8 2020. Disponível em: https://doi.org/10.1111/1753-0407.13084
YAN, Y.; YANG, F.; ZHU, X.; WANG, M. et al. Analysis of clinical features and pulmonary CT features of coronavirus disease 2019 (COVID-19) patients with diabetes mellitus. Endokrynol Pol, 71, n. 5, p. 367-375, 2020. Disponível em: https://doi.org/10.5603/EP.a2020.0055
YAN, Y.; YANG, Y.; WANG, F.; REN, H. et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ Open Diabetes Res Care, 8, n. 1, Apr 2020. Disponível em: https://doi.org/10.1136/bmjdrc-2020-001343
YE, Q.; WANG, B.; MAO, J. The pathogenesis and treatment of the `Cytokine Storm' in COVID-19. J Infect, 80, n. 6, p. 607-613, 06 2020. Disponível em: https://doi.org/10.1016/j.jinf.2020.03.037
YUAN, S.; LI, H.; CHEN, C.; WANG, F. et al. Association of glycosylated haemoglobin HbA1c levels with outcome in patients with COVID-19: A Retrospective Study. Journal of Cellular and Molecular Medicine, 25, n. 7, p. 3484-3497, Apr 2021. Article. Disponível em: https://doi.org/10.1111/jcmm.16431
ZHANG, Y.; CUI, Y.; SHEN, M.; ZHANG, J. et al. Association of diabetes mellitus with disease severity and prognosis in COVID-19: A retrospective cohort study. Diabetes Research and Clinical Practice, Jul 2020. Article. Disponível em: https://doi.org/10.1016/j.diabres.2020.108227
ZHOU, W.; YE, S.; WANG, W.; LI, S. et al. Clinical Features of COVID-19 Patients with Diabetes and Secondary Hyperglycemia. J Diabetes Res, 2020, p. 3918723, 2020. Disponível em: https://doi.org/10.1155/2020/3918723
