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Chikkahonnaiah P, Dallavalasa S, Tulimilli SV, Dubey M, Byrappa SH, Amachawadi RG, Madhunapantula SV, Veeranna RP. SARS-CoV-2 Infection Positively Correlates with Hyperglycemia and Inflammatory Markers in COVID-19 Patients: A Clinical Research Study. Diseases 2024; 12:143. [PMID: 39057114 PMCID: PMC11276363 DOI: 10.3390/diseases12070143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/22/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetes mellitus (DM) is a common comorbidity in COVID-19 subjects. Hyperglycemia at hospital admission identified as a major risk factor and is responsible for poor prognosis. Hematological and inflammatory parameters have been recognized as predictive markers of severity in COVID-19. In this clinical study, we aimed to assess the impact of hyperglycemia at hospital admission on hematological and several inflammatory parameters in COVID-19 patients. A total of 550 COVID-19 subjects were primarily categorized into two major groups (normoglycemic and hyperglycemic) based on random blood sugar levels. On the first day of hospitalization, subjects' oxygen saturation, random blood sugar, hematological variables, and inflammatory parameters were recorded. The hyperglycemic group exhibited higher levels of serum ferritin, total leukocyte count (TLC), lactate dehydrogenase (LDH), neutrophil count, and neutrophil-to-lymphocyte ratio (NLR). In contrast, oxygen saturation and lymphocyte count were lower compared to the normoglycemic group. Significantly elevated levels of hematological variables (TLC, neutrophil count, NLR) and inflammatory parameters (serum ferritin) were observed in the hyperglycemic group. Among inflammatory parameters, only serum ferritin levels showed statistical significance. This study supports the clinical association between hyperglycemia and an increased severity of COVID-19. Consequently, the identification of these parameters is a crucial and valuable prognostic indicator for assessing disease severity in hyperglycemic subjects.
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Affiliation(s)
- Prashanth Chikkahonnaiah
- Department of Pulmonary Medicine, Mysore Medical College and Research Institute, Mysuru 570001, Karnataka, India;
| | - Siva Dallavalasa
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
| | - SubbaRao V. Tulimilli
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
| | - Muskan Dubey
- Xavier University School of Medicine, Xavier University School of Veterinary Medicine, Santa Helenastraat #23, Oranjestad, Aruba;
| | - Shashidhar H. Byrappa
- Department of Pathology, Mysore Medical College and Research Institute (MMC&RI), Mysuru 570001, Karnataka, India;
| | - Raghavendra G. Amachawadi
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA;
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (DST-FIST Supported Centre and ICMR Collaborating Center of Excellence–ICMR-CCoE), Department of Biochemistry (DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570015, Karnataka, India; (S.D.); (S.V.T.)
- Leader, Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysuru 570004, Karnataka, India
| | - Ravindra P. Veeranna
- Xavier University School of Medicine, Xavier University School of Veterinary Medicine, Santa Helenastraat #23, Oranjestad, Aruba;
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Zhang Y, Chen S, Tian Y, Fu X. Host factors of SARS-CoV-2 in infection, pathogenesis, and long-term effects. Front Cell Infect Microbiol 2024; 14:1407261. [PMID: 38846354 PMCID: PMC11155306 DOI: 10.3389/fcimb.2024.1407261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 06/09/2024] Open
Abstract
SARS-CoV-2 is the causative virus of the devastating COVID-19 pandemic that results in an unparalleled global health and economic crisis. Despite unprecedented scientific efforts and therapeutic interventions, the fight against COVID-19 continues as the rapid emergence of different SARS-CoV-2 variants of concern and the increasing challenge of long COVID-19, raising a vast demand to understand the pathomechanisms of COVID-19 and its long-term sequelae and develop therapeutic strategies beyond the virus per se. Notably, in addition to the virus itself, the replication cycle of SARS-CoV-2 and clinical severity of COVID-19 is also governed by host factors. In this review, we therefore comprehensively overview the replication cycle and pathogenesis of SARS-CoV-2 from the perspective of host factors and host-virus interactions. We sequentially outline the pathological implications of molecular interactions between host factors and SARS-CoV-2 in multi-organ and multi-system long COVID-19, and summarize current therapeutic strategies and agents targeting host factors for treating these diseases. This knowledge would be key for the identification of new pathophysiological aspects and mechanisms, and the development of actionable therapeutic targets and strategies for tackling COVID-19 and its sequelae.
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Affiliation(s)
| | | | - Yan Tian
- Department of Endocrinology and Metabolism, Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Medical School, West China Hospital and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, Sichuan, Chengdu, China
| | - Xianghui Fu
- Department of Endocrinology and Metabolism, Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Medical School, West China Hospital and Cancer Center, Sichuan University and Collaborative Innovation Center of Biotherapy, Sichuan, Chengdu, China
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Tsikala Vafea M, Traboulsi C, Stefanovic-Racic M. Lower Glycosylated Hemoglobin Is Associated With Lower In-Hospital Mortality in Patients With COVID-19: A Systematic Review of the Literature and Meta-Analysis. Endocr Pract 2024; 30:70-77. [PMID: 37769967 DOI: 10.1016/j.eprac.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/02/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Poor glycemic control during COVID-19 hospitalization is associated with higher mortality. However, the association between long-term glycemic control, as reflected by the glycosylated hemoglobin (HbA1c) and outcomes has yet to be clarified, with some studies reporting no association. The aim of this study is to determine the association between HbA1c and in-hospital mortality in patients with COVID-19. METHODS Pubmed, Embase, and Web of Science databases were searched for studies examining the association between HbA1c level and in-hospital COVID-19 mortality. Random-effects meta-analysis was performed. Heterogeneity was assessed using the I2 statistic. Publication bias was assessed using funnel plots. RESULTS Among 4142 results, 22 studies were included in the final analysis with a total of 11 220 patients. Lower Hba1c was associated with lower in-hospital mortality [odds ratio (OR), 0.53; 95% CI, 0.37-0.76; I2 81%], in using HbA1c as a dichotomous variable. When only patients with diabetes were included in the analysis, the association remained statistically significant (OR, 0.67; 95% CI, 0.47-0.96). In the subgroup analysis, the association remained statistically significant in studies using as cutoff the HbA1c value of 6.5% (OR, 0.34; 95% CI, 0.15-0.77) and 7% (OR, 0.54; 95% CI 0.32-0.90), but not with greater HbA1c cutoff values; 7.5% and ≥8%. In studies using HbA1C as a continuous variable, HbA1c level did not have a statistically significant association with in-hospital mortality, either in univariate or multivariate analyses. CONCLUSION A better glycemic control prior to hospitalization, as reflected by lower HbA1c, is associated with lower in-hospital mortality in patients with COVID-19.
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Affiliation(s)
- Maria Tsikala Vafea
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| | - Cindy Traboulsi
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Maja Stefanovic-Racic
- Department of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Chen P, Wu M, He Y, Jiang B, He ML. Metabolic alterations upon SARS-CoV-2 infection and potential therapeutic targets against coronavirus infection. Signal Transduct Target Ther 2023; 8:237. [PMID: 37286535 DOI: 10.1038/s41392-023-01510-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/18/2023] [Accepted: 05/19/2023] [Indexed: 06/09/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by coronavirus SARS-CoV-2 infection has become a global pandemic due to the high viral transmissibility and pathogenesis, bringing enormous burden to our society. Most patients infected by SARS-CoV-2 are asymptomatic or have mild symptoms. Although only a small proportion of patients progressed to severe COVID-19 with symptoms including acute respiratory distress syndrome (ARDS), disseminated coagulopathy, and cardiovascular disorders, severe COVID-19 is accompanied by high mortality rates with near 7 million deaths. Nowadays, effective therapeutic patterns for severe COVID-19 are still lacking. It has been extensively reported that host metabolism plays essential roles in various physiological processes during virus infection. Many viruses manipulate host metabolism to avoid immunity, facilitate their own replication, or to initiate pathological response. Targeting the interaction between SARS-CoV-2 and host metabolism holds promise for developing therapeutic strategies. In this review, we summarize and discuss recent studies dedicated to uncovering the role of host metabolism during the life cycle of SARS-CoV-2 in aspects of entry, replication, assembly, and pathogenesis with an emphasis on glucose metabolism and lipid metabolism. Microbiota and long COVID-19 are also discussed. Ultimately, we recapitulate metabolism-modulating drugs repurposed for COVID-19 including statins, ASM inhibitors, NSAIDs, Montelukast, omega-3 fatty acids, 2-DG, and metformin.
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Affiliation(s)
- Peiran Chen
- Department of Biomedical Sciences, City University of Hong Kong, HKSAR, Hong Kong, China
| | - Mandi Wu
- Department of Biomedical Sciences, City University of Hong Kong, HKSAR, Hong Kong, China
| | - Yaqing He
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, Guangdong, China
| | - Binghua Jiang
- Cell Signaling and Proteomic Center, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Ming-Liang He
- Department of Biomedical Sciences, City University of Hong Kong, HKSAR, Hong Kong, China.
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Lu Y, Xing C, Lv X, Zhang C, Liu G, Chen F, Hou Z, Zhang D. Changes of ACE2 in different glucose metabolites and its relationship with COVID-19. Medicine (Baltimore) 2022; 101:e31102. [PMID: 36253996 PMCID: PMC9575400 DOI: 10.1097/md.0000000000031102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To study the changes and effects of angiotensin-converting enzyme 2 (ACE2)/angiotensin 1-7 (Ang1-7) and ACE/AngII in people with different glucose metabolisms and to explore the possible mechanisms underlying the severity of COVID-19 infection in diabetic patients. METHODS A total of 88 patients with type 2 diabetes, 72 patients with prediabetes (impaired fasting glucose, 30 patients; impaired glucose regulation, 42 patients), and 50 controls were selected. Changes and correlations of ACE2, Ang1-7 and other indicators were detected among the three groups. Patients were divided into four groups according to the course of diabetes: <1 year, 1-5 years, 5-10 years, and >10 years. ACE2 and Ang1-7 levels were compared and analyzed. RESULTS ACE2 and Ang1-7 increased with the severity of diabetes (P0 < .05 or P < .01). The levels of ACE2 and Ang1-7 in the longer course group were lower than those in the shorter course group, whereas the levels of ACE, Ang II, and interleukin-6 (IL-6) gradually increased (P < .05). Pearson correlation analysis showed that ACE2 was positively correlated with IL-6, FBG, and 2hPBG levels in the prediabetes group. In the diabetic group, ACE2 was positively correlated with Ang1-7 and negatively correlated with ACE, AngII, IL-6, and C-reactive protein levels. Multiple linear regression analysis showed that IL-6 and ACE were the main factors influencing ACE2 in the diabetic group. CONCLUSION SUBSECTIONS ACE2/Ang1-7 and ACE/AngII systems are activated, and inflammatory cytokine release increases in prediabetes. With the prolongation of the disease course, the effect of ACE2/Ang1-7 decreased gradually, while the effect of ACE/AngII increased significantly. Dysfunctions of ACE2/Ang1-7 may be one of the important mechanisms underlying the severity of COVID-19 infection in patients with diabetes.
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Affiliation(s)
- Yamin Lu
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
- *Correspondence: Yamin Lu, Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang 050051, China (e-mail: )
| | | | - Xiuqin Lv
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Cuigai Zhang
- Physical Examination Center, Hebei General Hospital, Shijiazhuang, China
| | - Guangxia Liu
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Fang Chen
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Zhan Hou
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Donghui Zhang
- Clinical Research Center, Hebei General Hospital, Shijiazhuang, China
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Tong X, Huang Z, Zhang X, Si G, Lu H, Zhang W, Xue Y, Xie W. Old Age is an Independent Risk Factor for Pneumonia Development in Patients with SARS-CoV-2 Omicron Variant Infection and a History of Inactivated Vaccine Injection. Infect Drug Resist 2022; 15:5567-5573. [PMID: 36172623 PMCID: PMC9512030 DOI: 10.2147/idr.s380005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Analyzing the risk factors for pneumonia development in breakthrough cases with a history of inactivated vaccine injection is important. The present study aimed to investigate the risk factors for pneumonia development during Omicron variant infection. Design and Methods The clinical data were retrospectively collected from 187 patients who previously received inactivated vaccine and were infected by the Omicron variant. Results Among the 187 patients, 73 had 2 doses of inactivated vaccine injection and the remaining 114 had 3 doses; 19 patients had pneumonia at admission. The univariate logistic analysis showed that age, baseline platelet count, D-dimer level, and CD8+ T lymphocyte count were associated with pneumonia development at admission. The multivariate analysis showed that only age was the independent risk factor for pneumonia development (odds ratio = 1.046, 95% confidence interval: 1.003-1.091, P = 0.04). With an optimal cutoff value of 46, 4.4% (4/91) patients in the age <46 years group and 15.63% (15/96) patients in the age ≥46 years group had pneumonia (χ 2 = 6.454, P = 0.01). Moreover, age negatively correlated with CD8+ T cell count, B cell count, and albumin and uric acid levels (all P < 0.01), while age positively correlated with the glucose level (P < 0.01). Conclusion Old age was the only independent risk factor for pneumonia development in patients with Omicron variant infection and a history of inactivated vaccine injection.
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Affiliation(s)
- Xuecheng Tong
- Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.,Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Zeyu Huang
- Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Xiujun Zhang
- Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.,Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Guocan Si
- Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Huifen Lu
- Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Wei Zhang
- Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Yuan Xue
- Institute of Hepatology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China.,Department of Infectious Diseases, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
| | - Weibin Xie
- Department of Anesthesiology, the Third People's Hospital of Changzhou, Changzhou, People's Republic of China
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Zhang X, Si G, Lu H, Zhang W, Zheng S, Huang Z, Liu L, Xue Y, Zheng G. SARS-CoV-2 omicron variant clearance delayed in breakthrough cases with elevated fasting blood glucose. Virol J 2022; 19:148. [PMID: 36100916 PMCID: PMC9468532 DOI: 10.1186/s12985-022-01877-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Omicron variant (B.1.1.529) is a dominant variant worldwide. However, the risk factors for Omicron variant clearance are yet unknown. The present study aimed to investigate the risk factors for early viral clearance of Omicron variant in patients with a history of inactivated vaccine injection. Methods Demographic, clinical, and epidemiological data from 187 patients were collected retrospectively during the Omicron variant wave. Results 73/187 and 114/187 patients were administered two and three doses of vaccine, respectively. The median duration of SARS-CoV-2 RNA positivity was 9 days, and the difference between patients with two and three vaccine injections was insignificant (P = 0.722). Fever was the most common symptom (125/187), and most patients (98.4%) had a fever for < 7 days. The RNA was undetectable in 65/187 patients on day 7. Univariable logistic analysis showed that baseline glucose, uric acid, lymphocytes count, platelet count, and CD4+ T lymphocyte count were associated with SARS-CoV-2 RNA-positivity on day 7. Multivariable analysis showed that glucose ≥ 6.1 mmol/L and CD4+T lymphocytes count were independent risk factors for RNA positivity on day 7. 163/187 patients had an undetectable RNA test on day 14, and uric acid was the only independent risk factor for RNA positivity. Moreover, baseline glucose was negatively correlated with uric acid and CD4+ and CD8+ T cell count, while uric acid was positively correlated with CD4+ and CD8+ T cell count. Conclusions Omicron variant clearance was delayed in breakthrough cases with elevated fasting blood glucose, irrespective of the doses of inactivated vaccine.
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Affiliation(s)
- Xiujun Zhang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Guocan Si
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Huifen Lu
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Wei Zhang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Shuqin Zheng
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Zeyu Huang
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China
| | - Longgen Liu
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China.,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China
| | - Yuan Xue
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China. .,Department of Infectious Diseases, The Third People's Hospital of Changzhou, Changzhou, China.
| | - Guojun Zheng
- Institute of Hepatology, The Third People's Hospital of Changzhou, No. 300 Lanling North Road, Changzhou, 213000, Jiangsu, China. .,Clinical Laboratory, The Third People's Hospital of Changzhou, Changzhou, China.
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