/dpa
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London – A Diabetes mellitus is not only one of the most important risk factors for a severe course of COVID-19. The infection with the Coronavirus SARS-CoV-2, apparently, can also trigger Diabetes and a severe metabolic decompensation, up to and including deadly ketoacidosis cause, warns a group of endocrinologists The New England Journal of Medicine (NEJM 2020; DOI: 10.1056/NEJMc2018688).
Metabolic abnormalities are under severe virus not uncommon diseases. In most cases, the stress response with increased secretion of Cortisol is to increase blood sugar responsible. In the case of the SARS-corona virus, an additional component seems to be added to. The first SARS epidemic in 2002/3, it was noticed that the patient often to a worsening of blood sugar control.
Chinese researchers attributed this later to damage to the Beta cells. In these cells is formed the Protein is ACE2, the SARS-CoV-2, the binding site for entry into cells (Acta Diabeto, Logica 2010; 47: 193-199).
It is, therefore, for diabetologists is not surprising that it also comes with COVID-19-patients often severe metabolic derangements, such as that described by Ying Jie Chee from Khoo Teck Puat Hospital in Singapore in the case of a younger patient who developed without risk factors and without previous evidence of insulin resistance in the context of a COVID-19-disease, Insulin-dependent Diabetes (Diabetes Research and Clinical Practice 2020; 164: 108166).
A Team led by Aiping Deng of the University in Wuhan, it was noticed that not less than 6.4 % of hospitalized COVID-19 patients had a rise in ketone body or a Ketonuria, wherein every third time before a Diabetes was known (a lack of Insulin is a major cause for an increase in ketone bodies).
The ketosis was associated with a severe course of COVID-19 and increased mortality, even if only 3 patients died of ketoacidosis (Diabetes, Obesity and Metabolism 2020; DOI: 10.1111/dom.14057).
Shujun Zhang, also of the University in Wuhan, reported in a further study, the triglyceride-glucose Index (a product of the two blood values, is a sign of insulin resistance) increases in many patients with COVID-19 significantly and that this increase, in turn, increases the risk of death (Cardiovascular Diabetology 2020; 19: 58).
These reports have prompted a Team led by Francesco Rubino of King’s College London now, a patient registry (CoviDIAB) to set up. It should clarify how frequently an ketosis at COVID-19 patients, whether it is a classic type-1 or type – 2 Diabetes, or to a new type of Diabetes and whether the patient recovers after surviving disease from the Diabetes.
The international Team of 17 Diabetes experts from nine countries. From Germany Stefan Bornstein, Director of the Medical clinic and policlinic III at the University hospital in Dresden is here. © rme/doctors sheet.de
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