The Effect of COVID-19 on Patients With Diabetes

Kimberly E. Ng, PharmD, BCPS; Joshua P. Rickard, PharmD, MPH, BCPS, BCACP, CDCES

Disclosures

US Pharmacist. 2020;45(11):9-13. 

In This Article

Abstract and Introduction

Abstract

Coronavirus 2019 (COVID-19) has quickly spread, infecting and claiming the lives of many as healthcare professionals around the globe work tirelessly to treat patients who become infected. According to the American Diabetes Association, at this time, there are insufficient data to show if those with diabetes are more likely to become infected with COVID-19; however, those with diabetes have worse outcomes, such as higher rates of serious complications. This article discusses proposed mechanisms associated with increased risk of negative COVID-19 outcomes in patients with diabetes, comorbidities, and management of diabetes in patients with COVID-19.

Introduction

Coronavirus disease 2019, or COVID-19, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in Wuhan, China in 2019 and rapidly spread across the world such that it was declared a pandemic by the World Health Organization on March 11, 2020.[1]

Since then, it has infected more than 5 million people in the United States, and the death toll continues to rise to more than 219,000 at the time of publication.[2] U.S. states that initially emerged as epicenters for COVID-19 were able to decrease community transmission with shelter-in-place orders, mandatory masks, and social distancing measures. COVID-19 can rapidly spread from person to person, through respiratory droplets produced through breathing, singing, talking, coughing, or sneezing. COVID-19 continues to be spread in the community in multiple states, prompting reversal of reopening plans.[3] According to the American Diabetes Association (ADA), at this time, there are insufficient data to show if those with diabetes are more likely to become infected with COVID-19; however, those with diabetes have worse outcomes, such as higher rates of serious complications.[4]

It is known that older adults and those with chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, and obesity are at increased risk for severe COVID-19 requiring hospitalization.[5] With a long incubation time reported to be up to 24 days and both symptomatic and asymptomatic carriers able to transmit the disease, COVID-19 has proven to be highly infectious.[6]

At this time, there is no effective cure for COVID-19. The most common symptoms of COVID-19 include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.[7]

A multitude of medications to treat COVID-19 patients have been and continue to be studied in clinical trials around the world. Some medications include remdesivir, lopinavir plus ritonavir, tocilizumab, anakinra, as well as convalescent plasma therapy. Most patients receive supportive care, and those who become severely ill may require mechanical ventilation.[6]

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