Effect of COVID19 Infection on the Immune System and Risk of Developing Diabetes Complications: A Review

Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. The pandemic outbreak of COVID-19 is rapidly spreading all over the world. In this review, we try to summarize studies of the relationship between the alteration of immune system during COVID-19 infection and the risk of developing diabetes complications. The data were collected by searching Science Direct, Google Scholar, PubMed, Scopus, Springer and National Center for Biotechnology Information (NCBI). The Keywords used as search terms were “COVID-19”, “SARS-COV2 induced inflammatory reaction”, “ACE2 and COVID-19 infection”, “Diabetes and Oxidative stress” and “COVID-19 induced Diabetes complication”. The risk of COVID-19 infection in patients is due to the severity of the viral infection and also to the host’s immune response. The risk of infection is one of the main complications of diabetics, as it has been suggested that diabetes inhibits the immune response which contributes to infection and progression to symptoms. Also, the evidence of generation of oxygen free radicals and oxidative stress is a key process in the onset of diabetes mellitus which participate in the development of the systemic inflammatory response syndrome. In addition, chronic hyperglycemia during COVID-19 infection may increase the release of inflammatory cytokines, a high ability to bind to the virus ACE2 glycosylated, worsen the ketoacidosis and vascular complications that may explain the severity of the SARS-CoV-2 infection in diabetic patients.