UNDERSTANDING THE PATHOPHYSIOLOGIC MECHANISMS AND INTERPLAY BETWEEN SARS-CoV-2 /COVID-19, OBESITY AND DIABETES WITH INCURSIONS INTO THE POST-PANDEMIC ERA

Dr. Chrysanthus Chukwuma Sr*

ABSTRACT

There have been articulations of disparate theories to contribute to the adverse prognosis and outcomes in patients with diabetes, obesity and COVID-19 predicaments. SARS-CoV-2 infection disrupts carbohydrate, lipid, and amino acid metabolism, instigating and enhancing disease progression. Pre-existing obesity and diabetes, with their associated inflammation and insulin resistance, facilitate SARS-CoV-2 infection. The viral infection then intensifies this metabolic and inflammatory dysfunction. Elevated hyperglycaemia, inflammation, and insulin resistance establish an increasingly favourable environment for viral replication and disease progression, culminating in a poorer prognosis. Numerous environmental states including ageing ambience, lifestyle and social disruptions have been indicted in the predisposition of these disorders. Basically, a disequilibrium between caloric ingress and energy dissipation elicits endocrine and/or metabolic responses exacerbating the age-dependent dysregulation in lipid and carbohydrate metabolism in vulnerable populations and SARS-CoV-2 susceptible individuals. This review explores the prevalence, underlying aetiologies, clinical repercussions, and management strategies in persons with T2DM, focusing on its impact on glycaemic control, treatment safety, and correlated outcomes. Type 2 Diabetes and obesity constitute a multidimensional influence on the risk of SARS-CoV-2/COVID-19, the attributes and mechanisms of the pathogenesis and pathophysiology of the viral infection. The manifestation of these diseases signify elevated risk of acquiring ardent and pertinent therapy, in order to obviate sequelae which could culminate in mortality. Extant pathophysiologic evidence do suggest, although persons presenting diabetes and obesity are as vulnerable to SARS-CoV-2 infection as those deficient of these disorders, the risk of clinical care in diabetes or obesity with contracting COVID-19 increases three-fold t 4.5 times or 4.5 times higher if presenting with diabetes and obesity combined. This review provides a valuable contribution to elucidating how metabolic derangements influence COVID-19 susceptibility, outcome and prognosis. It engages complex metabolic interplays and proposes dietary and therapeutic modalities targeted at these vulnerabilities. In conclusion, this review emerges as a pertinent resource for clinicians, public health experts, and researchers dedicated to address the dual burden of the similar COVID-19 pandemic and pre-existing metabolic aberrations. Its insights will be instrumental in carving more effective and efficient clinical interventions and public health approaches. Thus, the study provides a conceptus of the predominant characteristics of diabetes, obesity and SARS-CoV-2/COVID-19 pandemic as well as the associated carbohydrate-lipid interactions and metabolism which may potentially impact public health and the clinical process, including socioeconomic burden. Obesity and diabetes are pronounced comorbidities for SARS-CoV-2. The complex interactions between carbohydrate and lipid metabolism establish a reverting cycle that exacerbates the hallmarks of SARS-CoV-2. Obesity and diabetes both highlight systemic dysfunctions in carbohydrate and lipid metabolism which are aggravated by COVID-19 infection creating an anomalous feedback loop worsening metabolic disorders from COVID-19 outcomes, while the infection, in turn, exacerbates prevailing metabolic issues or triggers nascent problems. The COVID-19 pandemic culminated in an expansive mortality as a repercussion of the SARS-CoV-2. The SARS-COV-2 encompassed by a lipid bilayer promotes fusion of the viral membrane to the host cell, replication, endocytosis, exocytosis and functionality of lipid metabolism in viral infectivity. Deficiency in proper drugs and vaccines, constitute never-ending opportunities for antiviral treatments or therapies. Diet suffused with carbohydrates and saturated fats enhance obesity and diabetes prevalence, oxidative stress and comorbidities occurrence as risk attributes for COVID-19 pandemic as a public health enigma. COVID-19 outbreak has invariably constituted a traumatic albatross to global public health system with resultant stumbling strategies to obviate the disorder. However, carbohydrates may offer rapid diagnostics, proper, effective and efficient vaccines and therapeutic regimen.

Keywords:

Mortality, pathogenesis, public health, diet, COVID-19, macromolecular interactions.

Full Text Article