Diabetes and COVID-19: Zachary T. Bloomgarden

DOI: 10.1111/1753-0407.
13027
COMMENTARY
Diabetes and COVID-19
Zachary T. Bloomgarden
Department of Medicine, Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York
Correspondence
Zachary T. Bloomgarden, Department of Medicine, Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai,
New York, New York 10029.
Email: zbloom@gmail.com
After the recognition in December 2019 of a cluster of We acknowledge the frontline medical staff working
patients with pneumonia of unknown cause in day and night in China to rescue critical cases and pro-
Wuhan caused by the novel coronavirus, CoV-19,1 tect the public health. We know that these great efforts
China and the world have faced the extraordinary are now and will be in the future crucial in overcoming
challenge of a previously unrecognized viral illness COVID-19. Providing care to people with diabetes is an
with high infectivity.2 Every year, millions of persons important part of the effort. The Journal of Diabetes was
(5%-15% of the world's population) contract started more than a decade ago in a spirit of collaboration
influenza,3,4 causing between 300 000 and 600 000 between East and West addressing the epidemiology, eti-
excess respiratory deaths.5 In China alone, recent esti- ology, pathogenesis, management, complications, and
mates put the annual influenza-associated mortality prevention of diabetes. The journal is issuing a call for
rate at more than 88 000 persons,6 likely in excess of submission of commentaries, original articles, and case
any potential outcome of coronavirus disease 2019 reports regarding issues with COVID-19 in patients with
(COVID-19). Regardless of the potential for spread of diabetes, as well as descriptions of basic aspects of the
COVID-19, as with influenza-related mortality,7 dia- interrelationships between diabetes and the novel CoV.
betes is an important risk factor for adverse outcome. We hope in this way to support the thousands of Chinese
Mortality rates among persons with diabetes in Hong medical workers involving themselves in the care of
Kong age 75 and over from pneumonia currently patients with COVID-19, and we look forward to these
exceed mortality rates in this age group from cardio- efforts helping our goal of eradication of the disease.
vascular disease and from cancer.8 Similar evidence of
risk among persons with diabetes has been reported
RE FER EN CES
for the two earlier CoV infections, severe acute respi-
1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from
ratory syndrome (SARS) beginning in 2002 and affect-
patients with pneumonia in China. N Engl J Med. 2019. https://
ing more than 8000 persons, mainly in Asia9,10 and doi.org/10.1056/NEJMoa2001017.
the Middle East respiratory syndrome (MERS) in 2012 2. Li Q, Guan X, Wu P, et al. Early transmission dynamics in
affecting more than 2000 persons, mainly in Saudi Wuhan, China, of novel coronavirus-infected pneumonia.
Arabia.11 As MERS-CoV binds to the receptor-binding N Engl J Med. 2020. https://doi.org/10.1056/NEJMoa2001316.
domain of human dipeptidyl peptidase IV (DPP-IV), a 3. Nicholson KG, Wood JM, Zambon M. Influenza. Lancet. 2003;
transgenic mouse model expressing this DPP-IV 362:1733-1745.
receptor on pulmonary alveolar cells has been used to 4. World Health Organization. Influenza (Seasonal), downloaded
2020. https://www-who-int.eresources.mssm.edu/en/news-room/
study the effect of diabetes in worsening disease
fact-sheets/detail/influenza-(seasonal)
severity, showing an association of diabetes with 5. Iuliano AD, Roguski KM, Chang HH, et al. Global seasonal
greater weight loss and greater pulmonary inflamma- influenza-associated mortality collaborator network estimates
tion, with macrophage infiltrates similar to those seen of global seasonal influenza-associated respiratory mortality:
clinically in the disease.12 a modelling study. Lancet. 2018;391:1285-1300.
© 2020 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd
Journal of Diabetes. 2020;12:347–349. wileyonlinelibrary.com/journal/jdb 347

348 COMMENTARY
6. Li L, Liu Y, Wu P, et al. Influenza-associated excess respiratory outbreak: a population-based interrupted time series study.
mortality in China, 2010-15: a population-based study. Lancet J Formos Med Assoc. 2009;108:386-394.
Public Health. 2019;4:e473-e481. 10. Chan-Yeung M, Xu RH. SARS: epidemiology. Respirology.
7. Goeijenbier M, van Sloten TT, Slobbe L, et al. Benefits of flu 2003;8:S9-S14.
vaccination for persons with diabetes mellitus: a review. Vac- 11. Morra ME, Van Thanh L, Kamel MG, et al. Clinical outcomes
cine. 2017;35(38):5095-5101. of current medical approaches for Middle East respiratory syn-
8. Wu H, Lau ESH, Ma RCW, et al. Secular trends in all-cause drome: a systematic review and meta-analysis. Rev Med Virol.
and cause-specific mortality rates in people with diabetes in 2018;28:e1977.
Hong Kong, 2001-2016: a retrospective cohort study. 12. Kulcsar KA, Coleman CM, Beck SE, Frieman MB. Comorbid
Diabetologia. 2020. https://doi.org/10.1007/s00125-019-05074-7. diabetes results in immune dysregulation and enhanced dis-
9. Huang YT, Lee YC, Hsiao CJ. Hospitalization for ambulatory- ease severity following MERS-CoV infection. JCI Insight. 2019;
care-sensitive conditions in Taiwan following the SARS 4:131774.

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DOI: 10.1111/1753-0407.

Diabetes and COVID-19

Journal of Diabetes. 2020;12:347–349. wileyonlinelibrary.com/journal/jdb 347

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