Imminent risk of COVID-19 in diabetes mellitus and undiagnosed diabetes mellitus patients

Impact of the SARS-CoV-2 infection in individuals with sickle cell disease: an integrative review

Sickle cell disease is the most common hemoglobinopathy among humans. As the condition promotes susceptibility to infections, chronic inflammation, and hypercoagulability disorders, several international agencies have included individuals with this disease in the COVID-19 risk group for severe outcomes. However, available information about the subject is not properly systematized yet. This review aimed to understand and summarize the scientific knowledge about the impact of SARS-CoV-2 infection in patients with sickle cell disease. Searches were performed in the Medline, PubMed, and Virtual Health Library databases based on descriptors chosen according to the Medical Subject Headings. We analyzed studies published between 2020 and October 2022, developed with qualitative, quantitative, or mixed methodology, and written in English, Spanish, or Portuguese. The search resulted in 90 articles organized into six categories. There is disagreement in the literature about how different aspects related to sickle cell disease, such as chronic inflammation status, hypercoagulability, hemolytic anemia, use of hydroxyurea, and access to medical care interference with the clinical course of COVID-19. These topics deserve further investigation. It is evident, however, that the infection may manifest in an atypical way and act as a trigger for the development of sickle cell-specific complications, such as acute chest syndrome and vaso-occlusive crises, conditions that are associated with great morbidity and mortality. Therefore, healthcare professionals must be aware of the different forms of presentation of COVID-19 among these individuals. Specific guidelines and therapeutic protocols, as well as public policies for sickle cell individuals, must be considered.

Systematic review registration

This review (https://doi.org/10.17605/OSF.IO/NH4AS) and the review protocol (https://osf.io/3y649/) are registered in the Open Science Framework platform.

COVID-19-related thyroid conditions (Review)

In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may include either: A process of central thyroid stimulating hormone (TSH) disturbances via virus-related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage of the gland or low T3 (triiodothyronine) syndrome (so called non-thyroid illness syndrome) which is not specifically related to the COVID-19 infection, but which is associated with a very severe illness status. Our objective here was to briefly review thyroid changes due to the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/at acute phase of COVID-19 are encouraged in order to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the prognostic value of interleukin-6 in infected patients, especially in cases with cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.

SGLT-2 inhibitor intervention in diabetes mellitus patients can reduce the incidence of renal injury and adverse events

OBJECTIVE

To explore the therapeutic value of sodium-dependent glucose transporters 2 (SGLT-2) inhibitor in type 2 diabetes mellitus (DM).

METHODS

A total of 131 patients with type 2 DM admitted to our hospital from October 2017 to November 2019 were recruited as research objects, including 58 patients treated with insulin + metformin + acarbose as the control group (CG), and 73 patients treated with SGLT-2 inhibitor on the basis of control group as the study group (SG). The levels of blood glucose, serum creatinine (Scr), 24-hour urinary protein quantity, serum uric acid, and the incidence of adverse events were compared between the two groups.

RESULTS

After treatment, fasting blood glucose (FPG), 2 hours postprandial blood glucose (2hPG), body mass index (BMI), hemoglobin A1c (HbA1c), type IV collagen (CIV), procollagen type III (PCIII), serum creatinine (Scr), 24-hour urinary protein quantity and blood uric acid (UA) decreased significantly (P > 0.05), and they were lower in SG than in CG (P < 0.05). Besides, the total effective rate of SG was 95.89%, which was notably higher than that of CG (84.48%, P < 0.05). The adverse reaction rate (ADR) of patients in SG was notably lower than that in CG (P < 0.05).

CONCLUSION

SGLT-2 inhibitor can effectively control the blood glucose level of DM patients, and can reduce the incidence of renal injury and adverse events.