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The triumvirate: why hypertension, obesity, and diabetes are risk factors for adverse effects in patients with COVID-19

Journal

ACTA DIABETOLOGICA
Volume 58, Issue 7, Pages 831-843

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s00592-020-01636-z

Keywords

SARS-CoV-2; Viral infection; Comorbidities; ACE2

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The outbreak of COVID-19 caused by SARS-CoV-2 has become a pandemic, leading to a higher risk of severe infection in individuals with hypertension, obesity, diabetes, and related complications. There is an urgent need to develop evidence-based treatment methods to effectively manage chronic diseases in COVID-19 patients without affecting the severity of the infection.
The outbreak of coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a pandemic. The cellular receptor for SARS-CoV-2 entry is the angiotensin-converting enzyme 2, a membrane-bound homolog of angiotensin-converting enzyme. Henceforth, this has brought the attention of the scientific community to study the interaction between COVID-19 and the renin-angiotensin system (RAS), as well as RAS inhibitors. However, these inhibitors are commonly used to treat hypertension, chronic kidney disorder, and diabetes. Obesity is a known risk factor for heart disease, diabetes, and hypertension, whereas diabetes and hypertension may be indirectly related to each other through the effects of obesity. Furthermore, people with hypertension, obesity, diabetes, and other related complications like cardiovascular and kidney diseases have a higher risk of severe COVID-19 infection than the general population and usually exhibit poor prognosis. This severity could be due to systemic inflammation and compromised immune response and RAS associated with these comorbid conditions. Therefore, there is an urgent need to develop evidence-based treatment methods that do not affect the severity of COVID-19 infection and effectively manage these chronic diseases in people with COVID-19.

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