Copyright ©The Author(s) 2021.
World J Diabetes. Mar 15, 2021; 12(3): 215-237
Published online Mar 15, 2021. doi: 10.4239/wjd.v12.i3.215
Table 2 Cardiovascular severity in diabetes and non-diabetes coronavirus disease 2019 patients
Pathophysiology of CVD
Hypoxia↑ ↑In COVID-19 patients compared with non-DM cases, DM reduced pulmonary function by reduced levels of FVC and FEV1 this condition further deteriorated in COVID-19 causing hypoxia[126-128,134] ongoing ischemia results in hypoxia causing CVD
Cytokine storm↑ ↑In COVID-19 patients compared with non-DM cases, DM increases the severity of the cytokine storm is due to exaggerated inflammatory response[138-141]. Thus, it increases the endothelial dysfunction causing a decrease in plaque stability, and an increase in plaque rupture results in CVD
RAAS Dysregulation↑ ↑DM patients using ACE inhibitors and ARBs have increased ACE2 expression is beneficial to vascular health by reducing profibrotic and proinflammatory function. But increased ACE2 levels increase the entry of SARS-CoV-2 infection, which potentially results in loss of ACE2 in blood vessels in diabetes patients causing vascular complications like CVD (see Obukhov et al[154])