Pathways of Coagulopathy and Inflammatory Response in SARS-CoV-2 Infection among Type 2 Diabetic Patients

Author:

Akácsos-Szász Orsolya-Zsuzsa1,Pál Sándor2ORCID,Nyulas Kinga-Ilona1,Nemes-Nagy Enikő3,Fárr Ana-Maria4,Dénes Lóránd5,Szilveszter Mónika6,Bán Erika-Gyöngyi7,Tilinca Mariana Cornelia8,Simon-Szabó Zsuzsánna4ORCID

Affiliation:

1. Doctoral School, Faculty of Medicine, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

2. Department of Transfusion Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary

3. Department of Chemistry and Medical Biochemistry, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

4. Department of Pathophysiology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

5. Department of Anatomy, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

6. Clinic of Plastic Surgery, Mureș County Emergency Hospital, 540136 Târgu Mureș, Romania

7. Department of Pharmacology, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

8. Department of Internal Medicine I, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540142 Târgu-Mureș, Romania

Abstract

Chronic inflammation and endothelium dysfunction are present in diabetic patients. COVID-19 has a high mortality rate in association with diabetes, partially due to the development of thromboembolic events in the context of coronavirus infection. The purpose of this review is to present the most important underlying pathomechanisms in the development of COVID-19-related coagulopathy in diabetic patients. The methodology consisted of data collection and synthesis from the recent scientific literature by accessing different databases (Cochrane, PubMed, Embase). The main results are the comprehensive and detailed presentation of the very complex interrelations between different factors and pathways involved in the development of arteriopathy and thrombosis in COVID-19-infected diabetic patients. Several genetic and metabolic factors influence the course of COVID-19 within the background of diabetes mellitus. Extensive knowledge of the underlying pathomechanisms of SARS-CoV-2-related vasculopathy and coagulopathy in diabetic subjects contributes to a better understanding of the manifestations in this highly vulnerable group of patients; thus, they can benefit from a modern, more efficient approach regarding diagnostic and therapeutic management.

Funder

George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures

Publisher

MDPI AG

Subject

Inorganic Chemistry,Organic Chemistry,Physical and Theoretical Chemistry,Computer Science Applications,Spectroscopy,Molecular Biology,General Medicine,Catalysis

Reference101 articles.

1. (2022, December 30). WHO–Diabetes Mellitus Classification. Available online: https://www.who.int/publications/i/item/classification-of-diabetes-mellitus.

2. (2022, December 30). WHO–COVID-19. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.

3. Impact of COVID-19 Pandemic on Vascular Surgery Unit Activity in Central Romania;Kaller;Front. Surg.,2022

4. COVID-19 and Diabetes: A Comprehensive Review of Angiotensin Converting Enzyme 2, Mutual Effects and Pharmacotherapy;Xie;Front. Endocrinol. (Lausanne),2021

5. Arbănași, E.M., Halmaciu, I., Kaller, R., Mureșan, A.V., Arbănași, E.M., Suciu, B.A., Coșarcă, C.M., Cojocaru, I.I., Melinte, R.M., and Russu, E. (2022). Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients. Diagnostics, 12.

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