AUTHOR=Oliveira Tales Lyra , Melo Igor Santana , Cardoso-Sousa Léia , Santos Igor Andrade , El Zoghbi Mohamad Bassim , Shimoura Caroline Gusson , Georjutti Renata Pereira , Castro Olagide Wagner , Goulart Luiz Ricardo , Jardim Ana Carolina Gomes , Cunha Thúlio Marquez , Sabino-Silva Robinson TITLE=Pathophysiology of SARS-CoV-2 in Lung of Diabetic Patients JOURNAL=Frontiers in Physiology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2020.587013 DOI=10.3389/fphys.2020.587013 ISSN=1664-042X ABSTRACT=

Novel coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its impact on patients with comorbidities is clearly related to fatality cases, and diabetes has been linked to one of the most important causes of severity and mortality in SARS-CoV-2 infected patients. Substantial research progress has been made on COVID-19 therapeutics; however, effective treatments remain unsatisfactory. This unmet clinical need is robustly associated with the complexity of pathophysiological mechanisms described for COVID-19. Several key lung pathophysiological mechanisms promoted by SARS-CoV-2 have driven the response in normoglycemic and hyperglycemic subjects. There is sufficient evidence that glucose metabolism pathways in the lung are closely tied to bacterial proliferation, inflammation, oxidative stress, and pro-thrombotic responses, which lead to severe clinical outcomes. It is also likely that SARS-CoV-2 proliferation is affected by glucose metabolism of type I and type II cells. This review summarizes the current understanding of pathophysiology of SARS-CoV-2 in the lung of diabetic patients and highlights the changes in clinical outcomes of COVID-19 in normoglycemic and hyperglycemic conditions.