As can be seen, the daily count of Coronavirus cases and fatalities is increasing at an unprecedented rate. In fact, any person of any age has the same risk factors for contracting the virus as the next person. On the negative side, diabetes is a poor prognostic factor for Coronavirus infection.
So what is the link between Coronavirus and diabetes?
Novel Coronavirus Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) Coronavirus 2019 (COVID-19)
In fact, a likely source of the Coronavirus was a wild animal food market, “wet market” in Wuhan City, China. Specifically, it formed from a bat coronavirus and mutated to a Pangolin Coronavirus. Then again, mutated in the reservoir of the Pangolin, through zoonosis passed on to inoculate (infect) a human.
To point out, zoonosis is an infectious disease that spreads from non-human animals to humans. Finally, the coronavirus reached the perfect host, a human, mutated, multiplied and became Coronavirus-2019 (COVID-19). In general, after a person talks, sneezes, or coughs, the Coronavirus can be transmitted by air droplets.
At the same time, the distance can range from 3 to 6 ft (1 to 2 m) away. For this reason, this is why we must practice “social distancing”. Similarly, touching hands on certain surfaces and then touching the mucus membranes (T-zone) can spread the virus.
To clarify, the T-zone is your eyes, nose and mouth (mucous membranes).
In reality, the incubation period of COVID-19 is 2-14 days. As a result, the CDC says you can experience symptoms such as fever, cough, or shortness of breath. On the other hand, is it the Coronavirus or are there other underlying factors, increasing your susceptibility?
In fact, most people will have a mild to moderate case, which means cold symptoms to a bad flu. Similarily, COVID-19, causes milder symptoms in about 80 percent of cases, while the remainder are severe or critical.
However, if COVID-19 worsens and inflammation develops. Then, patients might start out with a fever and cough that progresses to pneumonia or worse. Identically, COVID-19 seems to follow other virus patterns like SARS and MERS.
3 Phases of SARS
All things considered, after the SARS 2002 outbreak, the WHO reported that the virus attacked the lungs in three phases.
Phase 1, is the viral replication phase, usually lasts for about a week after symptom start. In fact, viruses will increase in respiratory secretions (droplets), stool and urine. In any event, the start of an infection, the coronavirus rapidly spreads and invades the lungs.
At this instant, Chest X-rays and computed tomography (CT) scans show slowly progressing lung damage.
Phase 2, is the immune hyper-reactive phase, damage to the lungs is a result of the body’s immune system. In essence, the body tries to fight the virus and sends immune cells to repair the lung tissue. But sometimes your immune system goes crazy and these cells destroy everything in it’s path, including healthy tissue.
In fact, studies have shown that many COVID-19 patients develop pneumonia in both lungs, accompanied by shortness of breath. Finally, fever may increase, oxygen may decrease, pneumonia or development of adult respiratory distress syndrome (ARDS) will occur. Furthermore, dead cells clog up the lungs, and pneumonia worsens.
Surprisingly, rather than healing, there is more damage to the body from the immune system response. For this reason, a storm builds, known as a Cytokine Storm Syndrome causing self inflicted immune system response damage.
Phase 3, is the pulmonary (lungs) destruction phase. For the most part, fever has usually disappeared unless there are other infections. However lung damage may continue or progress towards a honeycomb-like pattern on a CT scan. Furthermore, these lesions are present in those affected by COVID-19.
In effect, permanent injury and fibrosis (scarring) of the lung will set in and the patient may die. However, as a result of respiratory failure some may need ventilators or may recover with lung damage. Consequently, not all patients go through three phases.
In fact, 25 percent of SARS patients suffered respiratory failure, the signature of severe cases. In summary, this holds true for people who are older or have impaired immune systems.
Mortality (Death Rate)
Overall, globally, 3.4 % of reported COVID-19 cases have died. In comparison, the seasonal flu kills fewer than 1% of those infected(1). Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).
The rate may be lower because they didn’t include the asymptomatic (milder cases) and not reported. The rate is changing daily and will not reflect the posted rate. In detail, go here for the latest daily statistics.
“It’s going to get worse before it gets better,” says Donald Trump. In essence, this is no ordinary flu, it is much more aggressive.
Comorbidity means the incidence or presence of at least one condition or disease. Since, those suffering serious effects have pre-existing conditions. In fact, if you have a pre-existing condition then the risk of death is around 10 %; correspondingly, risk of critical illness increases to 40 % if you contract Coronavirus.
Surprisingly, statistics show that diabetics have a 7.3 % higher chance of fatality than someone with no condition. On the other hand, people with no other known conditions have a 0.9 % fatality rate(2). Not managing high blood sugar will lead to so many other chronic complications and possibly death.
Above all, you need to take care of yourself or help a loved one to manage their diabetes.
In fact, high blood sugar is toxic which causes problems in every single cell in your body. Since uncontrolled diabetes is a condition of impaired immunity and risk factor. In addition, infection may increase susceptibility towards COVID-19 and worsen the outcome.
In particular, according to the International Diabetes Foundation (IDF), older people and diabetics can become severely ill with COVID-19. People with diabetes who develop a viral infection are harder to treat due to fluctuations in blood glucose levels. Additionally, diabetes complications make the condition worse.
A compromised immune system means a longer healing period because the virus thrives in elevated blood sugar. Another factor related to Type 2 Diabetes and Metabolic Syndrome are inflammatory conditions related to excessive insulin. In fact, this chronic, systemic inflammation known as insulin resistance predisposes you to complications from infection.
In other words, not only will cuts take longer to heal but any condition like infections. Equally important, normalizing your blood sugar and insulin is the key to reducing inflammation and is critical to survive COVID-19. Furthermore, diabetes is a heterogeneous condition, as a result, not all diabetics will have poor outcomes.
Factors Affecting Outcome
- How long have you had diabetes?
- Degree of hyperglycemia, (how high is your blood sugar?)
- Other chronic complications and acute comorbidities (for example hypertension, neuropathy, and retinopathy)
- Monitor and control your glucose
- Try to remain stress free, because stress will increase glucose levels
- Keep yourself hydrated, drink water, coffee or tea
- Ensure you have a good supply of medications, in case you need to quarantine
- Go out for food, gas or other necessities as needed
- Do not change your lifestyle, this is not a good time to start exercising vigorously and restrict carbohydrates
- Practice social distancing
- Reduce the curve
- Have all relevant contact details
- Make sure you have access to enough food
- Ensure you can correct a hypoglycemic situation, fresh fruit like an apple or banana works great
- If you live alone, have a contact number of a friend and doctor if you get ill
- Have a plan so that if you do become infected you will be ready.
Infected COVID-19 Diabetics
- If you show flu-like symptoms (fever, cough, difficulty breathing), seek medical support and treatment immediately
- Follow medical support advice, try to manage optimal glucose levels.
How To Stay Safe
In the long run, for people with diabetes, it’s important to take precautions to avoid the virus if possible. In brief, keep a social distance of 6 feet and do not gather in groups of more than 10. To emphasize, you will hear this from health officials everyday, wash hands regularly and avoid touching your T-zone.
Stay home as much as possible, isolate yourself, now is the time to act. On the whole, the IDF and ADA encourage diabetics to keep informed of the latest developments. For this reason, watch for daily updates and advice from local, federal and reliable news sources.
Additionally, have a look at this video from Ninja Nerd Science, he discusses the epidemiology, pathology and diagnosis of coronavirus.
Finally, declared as a pandemic, COVID-19 continues to ravage people’s health. As a result, thousands have been victimized by this mysterious illness. At the same time, as the virus spreads so does the misinformation. In these learning times, we need to separate fact from fiction, so you can take steps to safeguard your health.
After all, it’s not the end of the world YET! Have faith and pray for people to use common sense. Keep Safe and Stay Healthy.
Above all, thanks for reading and I appreciate your comments.
- WHO Director-General’s opening remarks at the media briefing on COVID-19 – 3 March 2020 – World Health Organization, March 3, 2020
Images courtesy of NIAID-RML