The role of diabetes mellitus and obesity in COVID 19 patients
More details
Hide details
Internist – Intensivist, Consultant, Department of Emergency Medicine, University Hospital “Attikon”, Athens, Greece
Professor Critical Care Medicine, Department of Critical Care Medicine, University Hospital “Attikon”, Athens, Greece
Assist. Professor Internal Medicine, 2nd Propaedeutic Department of Internal Medicine, University Hospital “Attikon” Athens, Greece
Corresponding author
Maria Panagiota Almyroudi   

Department of Emergency Medicine, “Attikon” University Hospital, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini Street, 12462, Haidari, Greece
Pneumon 2020;33(3):114-117
Several risk factors (old age, hypertension, cardiovascular disease, immunodeficiency) have been related with coronavirus disease 2019 (COVID 19). Among them, Diabetes Mellitus (DM) and obesity are recognized to increase the susceptibility and severity of the infection. A higher inflammatory response observed in these patients, the immune system dysfunction and increased expression of angiotensin converting enzyme 2 (ACE2) which is a the target for SARS-CoV-2, contribute to the worse outcome of diabetic and obese patients. Adequate blood glucose control improves the prognosis, while critically ill COVID 19 patients with high metabolic risk should be monitored for new onset DM.
Antoniou K, Bolaki M, Bibaki E et al. COVID19 alert Do we know our enemy? Pneumon 2020, 33:25-7.
Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med 2020;382:2012-22.
Singh A-K, Gupta R, Ghosh A, Misrab A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr 2020; 14:303–10.
Hu Y, Sun J, Dai Z, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. J Clin Virol 2020;127.
Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. J Am Med Assoc 2020;323:1574–81.
Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA 2020;323:2052-9.
Bornstein SR, Rubino F, Khunti K, et al. Practical recommendations for the management of diabetes in patients with COVID-19. Lancet Diabetes Endocrinol 2020; 8:546–50.
Chow N, Fleming-Dutra K, Gierke R, et al. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:382–6.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020;323:1239-42.
Zeng-Hong Wu, Yun Tang, Qing Cheng. Diabetes increases the mortality of patients with COVID-19: a meta-analysis. Acta Diabetol 2020;1-6.
Wei-Jie Guan, Zheng-Yi Ni, Yu Hu, et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;382:1708-20.
Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and metaregression. Diabetes Metab Syndr Jul-Aug 2020;14:395-403.
Tahapary, Tamaraa A, Dicky L. Obesity as a predictor for a poor prognosis of COVID-19: A systematic review. Diabetes Metab Syndr 2020; 14:655–9.
Palaiodimos L, Kokkinidis DG, Li W, et al. Severe obesity is associated with higher in-hospital mortality in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism 2020;108:154262.
Cai Q, Chen F, Wang T, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care 2020; dc200576.
Gao F, Zheng KI, Wang X-B, et al. Obesity is a risk factor for greater COVID-19 severity. Diabetes Care 2020; 43:e72-e74.
Halvatsiotis P, Kotanidou A, Tzannis K, et al. Demographic and clinical features of critically ill patients with COVID-19 in Greece: The burden of diabetes and obesity. Diabetes Res Clin Pract 2020;166:108331.
Papadokostaki E, Tentolouris N, Liberopoulos E. COVID-19 and diabetes: What does the clinician need to know? Prim Care Diabetes 2020; S1751-9918(20)30222-9.
Guo W, Li M, Dong Y, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev 2020:e3319.
Zhu L, She Z-G, Chen X, et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metab 2020;31:1068-77.
Steiropoulos P, Bouros D. Obesity and pneumonia. A complex relationship. Pneumon 2014, 27:291-2.
Akhtar Hussain, Bishwajit Bhowmik, Nayla Cristina do Vale Moreirab. COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract 2020; 162:108142.
Rayman G, Lumb A, Kennon B, Cottrell C, et al. London Inpatient Diabetes Network-COVID-1. Guidelines for the management of diabetes services and patients during the COVID-19 pandemic. Diabet Med 2020;37:1087-9.
Jin-Kui Yang, Shan-Shan Lin, Xiu-Juan Ji, Li-Min Guo. Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes. Acta Diabetol 2010;47:193-9.
Journals System - logo
Scroll to top