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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Letter to the Editor in Response to article: “Clinical considerations for patients with diabetes in times of COVID-19 epidemic (Gupta <italic>et al.)</italic></title><author><name sortKey="Hussain, Akhtar" sort="Hussain, Akhtar" uniqKey="Hussain A" first="Akhtar" last="Hussain">Akhtar Hussain</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32325393</idno><idno type="pmc">7165078</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7165078</idno><idno type="RBID">PMC:7165078</idno><idno type="doi">10.1016/j.dsx.2020.04.022</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000453</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000453</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Letter to the Editor in Response to article: “Clinical considerations for patients with diabetes in times of COVID-19 epidemic (Gupta <italic>et al.)</italic></title><author><name sortKey="Hussain, Akhtar" sort="Hussain, Akhtar" uniqKey="Hussain A" first="Akhtar" last="Hussain">Akhtar Hussain</name></author></analytic><series><title level="j">Diabetes & Metabolic Syndrome</title><idno type="ISSN">1871-4021</idno><idno type="eISSN">1878-0334</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wu, C" uniqKey="Wu C">C. Wu</name></author><author><name sortKey="Chen, X" uniqKey="Chen X">X. Chen</name></author><author><name sortKey="Cai, Y" uniqKey="Cai Y">Y. Cai</name></author><author><name sortKey="Xia, J" uniqKey="Xia J">J. Xia</name></author><author><name sortKey="Zhou, X" uniqKey="Zhou X">X. Zhou</name></author><author><name sortKey="Xu, S" uniqKey="Xu S">S. Xu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, B" uniqKey="Li B">B. Li</name></author><author><name sortKey="Yang, J" uniqKey="Yang J">J. Yang</name></author><author><name sortKey="Zhao, F" uniqKey="Zhao F">F. Zhao</name></author><author><name sortKey="Zhi, L" uniqKey="Zhi L">L. Zhi</name></author><author><name sortKey="Wang, X" uniqKey="Wang X">X. Wang</name></author><author><name sortKey="Liu, L" uniqKey="Liu L">L. Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gupta, R" uniqKey="Gupta R">R. Gupta</name></author><author><name sortKey="Ghosh, A" uniqKey="Ghosh A">A. Ghosh</name></author><author><name sortKey="Singh, A K" uniqKey="Singh A">A.K. Singh</name></author><author><name sortKey="Misra, A" uniqKey="Misra A">A. Misra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Knapp, S" uniqKey="Knapp S">S. Knapp</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abregu, A V" uniqKey="Abregu A">A.V. Abregú</name></author><author><name sortKey="Carrizo, T R" uniqKey="Carrizo T">T.R. Carrizo</name></author><author><name sortKey="Diaz, E I" uniqKey="Diaz E">E.I. Díaz</name></author><author><name sortKey="Velarde, M S" uniqKey="Velarde M">M.S. Velarde</name></author><author><name sortKey="Fonio, M C" uniqKey="Fonio M">M.C. Fonio</name></author><author><name sortKey="Bazan, M C" uniqKey="Bazan M">M.C. Bazán</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Diabetes Metab Syndr</journal-id><journal-id journal-id-type="iso-abbrev">Diabetes Metab Syndr</journal-id><journal-title-group><journal-title>Diabetes & Metabolic Syndrome</journal-title></journal-title-group><issn pub-type="ppub">1871-4021</issn><issn pub-type="epub">1878-0334</issn><publisher><publisher-name>Published by Elsevier Ltd on behalf of Diabetes India.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32325393</article-id><article-id pub-id-type="pmc">7165078</article-id><article-id pub-id-type="publisher-id">S1871-4021(20)30087-4</article-id><article-id pub-id-type="doi">10.1016/j.dsx.2020.04.022</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Letter to the Editor in Response to article: “Clinical considerations for patients with diabetes in times of COVID-19 epidemic (Gupta <italic>et al.)</italic></article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Hussain</surname><given-names>Akhtar</given-names></name><email>hussain.akhtar@nord.no</email><xref rid="cor1" ref-type="corresp">∗</xref></contrib></contrib-group><aff id="aff1">NORD University, Norway</aff><aff id="aff2">Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Brazil</aff><aff id="aff3">International Diabetes Federation (IDF)</aff><aff id="aff4">Diabetes Asian Study Group (DASG)</aff><contrib-group><contrib contrib-type="author" id="au2"><name><surname>do Vale Moreira</surname><given-names>Nayla Cristina</given-names></name></contrib></contrib-group><aff id="aff5">University of Oslo, Norway</aff><aff id="aff6">Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Brazil</aff><author-notes><corresp id="cor1"><label>∗</label>Corresponding author. <email>hussain.akhtar@nord.no</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>18</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>18</day><month>4</month><year>2020</year></pub-date><permissions><copyright-statement>© 2020 Published by Elsevier Ltd on behalf of Diabetes India.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions></article-meta></front><body><p content-type="salutation">Dear Sir:</p><p id="p0010">As of today’s reports, the global number of confirmed cases of COVID-19 has surpassed 150,000. The number of known cases is increasing by several thousand every day. On March 11, 2020, WHO publicly characterized COVID-19 as a pandemic. The issue is of serious concern and deserves momentous attention.</p><p id="p0015">Coronaviruses are a family of viruses that cause respiratory illnesses. Most of them cause illness in animals, but seven known types of coronaviruses cause illness in humans. The coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) is one of those viruses – it causes the illness currently known as Coronavirus Disease-2019 (COVID-19).</p><p id="p0020">Though we are still learning what exactly puts someone at greater risk of developing a severe illness with COVID-19, early information indicates older patients and those with chronic medical conditions such as hypertension, diabetes and cardio-cerebrovascular diseases may be at higher risk (<xref rid="bib1" ref-type="bibr">1</xref>, <xref rid="bib2" ref-type="bibr">2</xref>, <xref rid="bib3" ref-type="bibr">3</xref>). Infection caused by COVID-19 is likely to disturb metabolic regulation. Diabetic patients with COVID-19 may face an altered immune response on the background of an already compromised health status owing to the diabetes-related complications and/or aging.</p><p id="p0025">The most important findings in patients with hyperglycemia and a viral infection were significant worsening of symptoms, which implies greater morbidity in these patients when compared to those without diabetes (<xref rid="bib3" ref-type="bibr">3</xref>). However, the pathophysiology of this association remains uncertain. It is not known whether hyperglycemia changes the virulence of the infection, or if the virus modifies the glycemic metabolism. What we know is that diabetic patients are more susceptible to infection, and this can impact on glucose metabolism (<xref rid="bib4" ref-type="bibr">4</xref>). DM is not just a disorder of glucose metabolism, but a chronic inflammatory condition characterized by multiple changes in lipid, carbohydrate and protein profiles (<xref rid="bib5" ref-type="bibr">5</xref>). Such inflammatory processes are due to hyperglycemia which leads to increased synthesis of glycosylation end products (AGEs), activates macrophages and other cells of the immune system, increase oxidative stress and promote the synthesis of pro-inflammatory cytokines, besides stimulating the synthesis of adhesion molecules that facilitate inflammation in the tissues (<xref rid="bib5" ref-type="bibr">5</xref>). The inflammatory process and its complications might provide a higher propensity to infections or a greater severity of these conditions. Another important issue is how this inflammatory and immune response occur in diabetic patients who acquire a viral infection, as well as whether the virus itself interferes with insulin secretion or the glycemic control.</p><p id="p0030">At this stage, the biological mechanism of the relationship between COVID-19 and diabetes is not known, but the association for the severity of cases and death is pronounced. We need to develop a hypothesis to explain the causal path underlying the more severe clinical presentation of COVID-19 infection and subsequent death in diabetic patients. Biochemical tests are also essential to clarify the molecular pathophysiology involved.</p><p id="p0035">The association of COVID-19 and DM is of substantial public health importance and deserves proper attention, since a large and diverse population is being affected globally. Nowadays this comorbidity poses a relevant threat to human health, and prospective well-designed studies to elucidate the biological mechanism and the best clinical management of this association are urgently needed.</p></body><back><ref-list id="cebib0010"><title>References</title><ref id="bib1"><label>1</label><element-citation publication-type="journal" id="sref1"><person-group person-group-type="author"><name><surname>Wu</surname><given-names>C.</given-names></name><name><surname>Chen</surname><given-names>X.</given-names></name><name><surname>Cai</surname><given-names>Y.</given-names></name><name><surname>Xia</surname><given-names>J.</given-names></name><name><surname>Zhou</surname><given-names>X.</given-names></name><name><surname>Xu</surname><given-names>S.</given-names></name></person-group><article-title>Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China</article-title><source>JAMA Intern Med</source><year>2020</year></element-citation></ref><ref id="bib2"><label>2</label><element-citation publication-type="journal" id="sref2"><person-group person-group-type="author"><name><surname>Li</surname><given-names>B.</given-names></name><name><surname>Yang</surname><given-names>J.</given-names></name><name><surname>Zhao</surname><given-names>F.</given-names></name><name><surname>Zhi</surname><given-names>L.</given-names></name><name><surname>Wang</surname><given-names>X.</given-names></name><name><surname>Liu</surname><given-names>L.</given-names></name></person-group><article-title>Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China</article-title><source>Clin Res Cardiol</source><year>2020</year></element-citation></ref><ref id="bib3"><label>3</label><element-citation publication-type="journal" id="sref3"><person-group person-group-type="author"><name><surname>Gupta</surname><given-names>R.</given-names></name><name><surname>Ghosh</surname><given-names>A.</given-names></name><name><surname>Singh</surname><given-names>A.K.</given-names></name><name><surname>Misra</surname><given-names>A.</given-names></name></person-group><article-title>Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes & Metabolic Syndrome</article-title><source>Clinical Research & Reviews</source><volume>14</volume><year>2020</year><fpage>211</fpage><lpage>212</lpage></element-citation></ref><ref id="bib4"><label>4</label><element-citation publication-type="journal" id="sref4"><person-group person-group-type="author"><name><surname>Knapp</surname><given-names>S.</given-names></name></person-group><article-title>Diabetes and infection: is there a link?--A mini-review</article-title><source>Gerontology</source><volume>59</volume><issue>2</issue><year>2013</year><fpage>99</fpage><lpage>104</lpage><pub-id pub-id-type="pmid">23182884</pub-id></element-citation></ref><ref id="bib5"><label>5</label><element-citation publication-type="journal" id="sref5"><person-group person-group-type="author"><name><surname>Abregú</surname><given-names>A.V.</given-names></name><name><surname>Carrizo</surname><given-names>T.R.</given-names></name><name><surname>Díaz</surname><given-names>E.I.</given-names></name><name><surname>Velarde</surname><given-names>M.S.</given-names></name><name><surname>Fonio</surname><given-names>M.C.</given-names></name><name><surname>Bazán</surname><given-names>M.C.</given-names></name></person-group><article-title>Subclinical inflammation in children and adolescents with type 1 diabetes</article-title><source>Acta Bioquím Clín Latino Am</source><volume>49</volume><year>2015</year><fpage>393</fpage><lpage>398</lpage></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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