Covid-19 and diabetes: the risk of a worse prognosis of SARS-CoV-2 infection increases not due to a single factor, but to the simultaneous presence of several cardio-metabolic risk factors
Two interdisciplinary studies carried out thanks to a close collaboration between the Diabetes, Infectious Diseases and Intensive Care departments of the three hospitals of Sapienza, Policlinico Umberto I and Sant'Andrea in Rome and Santa Maria Goretti in Latina, have shed light on the characteristics of the diabetic population affected by Covid-19.
The research, coordinated by Raffaella Buzzetti, Claudio Maria Mastroianni and Francesco Pugliese, identified the main factors that, in people with diabetes mellitus, are most associated with a worse prognosis of SARS-CoV-2 infection, namely cardio-metabolic multimorbidity, chronic obstructive pulmonary disease and chronic kidney failure, the common denominator of which is insulin resistance.
In the first paper, published in the Diabetes Research and Clinical Practice journal, the official body of the International Diabetes Federation (IDF), the researchers compared patients with diabetes mellitus hospitalised for SARS-CoV-2 infection with patients who had not contracted the infection. "This", says Raffaella Buzzetti of the Department of Experimental Medicine of Sapienza, "has allowed us to observe the presence of chronic obstructive pulmonary disease and chronic kidney failure as the main "accessory" pathologies that predispose the population with diabetes to an increased risk of hospitalisation for the Covid-19 disease."
The second paper, published in the Cardiovascular Diabetology journal, deepened the data obtained by the team in the first study, demonstrating that patients hospitalised for Covid-19 present multiple and concomitant cardio-metabolic diseases, such as diabetes mellitus, hypertension and dyslipidemia (i.e., increased plasma cholesterol and triglycerides).
"Our results", concludes Buzzetti, "highlights the importance of good primary cardiovascular prevention, to be carried out through strict control of risk factors for the heart and blood vessels, in order to reduce access to intensive care and mortality among patients affected by Covid-19." The scientific collaboration behind these important studies has started the interdisciplinary research group "Coronavirus & Diabetes (CoViDiab) Study Group", which includes several operating units of the Umberto I General Hospital (the Diabetology Unit directed by Raffaella Buzzetti, Anaesthesia and Intensive Care Departments coordinated by Francesco Pugliese, Infectious Diseases Wards coordinated by Claudio Mastroianni), the Sant'Andrea Hospital's Anaesthesia and Intensive Care Ward led by Monica Rocco, the Infectious Diseases Ward of the Santa Maria Goretti Hospital in Latina led by Miriam Lichtner and the Diabetology and Intensive Care Wards of the Campus Biomedico University hospital coordinated respectively by Paolo Pozzilli and Felice Eugenio Agrò.
Clinical features of patients with type 2 diabetes with and without Covid-19: a case control study (CoViDiab I) − Ernesto Maddaloni, Luca D'Onofrio, Francesco Alessandri, Carmen Mignogna, Gaetano Leto, Lucia Coraggio, Sara Sterpetti, Giuseppe Pascarella, Ivano Mezzaroma, Miriam Lichtner, Paolo Pozzilli, Felice Eugenio Agrò, Monica Rocco, Francesco Pugliese, Claudio Maria Mastroianni, Raffaella Buzzetti, the CoViDiab Study group − Diabetes Research and Clinical Practice, 2020. DOI https://doi.org/10.1016/j.diabres.2020.108454
Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II) − Ernesto Maddaloni, Luca D’Onofrio, Francesco Alessandri, Carmen Mignogna, Gaetano Leto, Giuseppe Pascarella, Ivano Mezzaroma, Miriam Lichtner, Paolo Pozzilli, Felice Eugenio Agrò, Monica Rocco, Francesco Pugliese, Andrea Lenzi, Rury R. Holman, Claudio Maria Mastroianni and Rafaella Buzzetti on behalf of the CoViDiab Study Group −Cardiovascular Diabetology, 2020. DOI https://doi.org/10.1186/s12933-020-01140-2
Department of Experimental Medicine