Abstract
Several factors are linked with a higher risk of mortality from Coronavirus disease-19 (COVID-19), including male gender, increased age, hypertension, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, and cancer. Hyperglycemic COVID-19 patients have severe clinical problems, increased ICU admittance, machine-driven ventilation, and a substantial rise in inflammatory markers. Among all patients, those with diabetes or hyperglycemia have a two- to four-fold increase in mortality and severity of COVID-19 than those without diabetes. The primary cause of mortality in COVID-19 patients with diabetes is compromised immune response to viral infections. Increased blood sugar level probably affects intracellular degradation of bacteria, neutrophil chemotaxis, and phagocytosis, thus improving viral binding affinity and entry and decreasing virus clearance. In addition, it has significant effects on the proteins by inducing glycosylation and altering the composition of complements, and glycosylation renders cells susceptible to viral inflammation and damage. The treatment of COVID-19 in patients with diabetes requires an integrated team approach to minimize the risk of medical complications and mortality. Moreover, physicians should adopt proactive strategies to care for persons with comorbidities. This strategy would help reduce the frequency of complications and mortality among patients and load on the healthcare system.