Letter to the Editor Open Access
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Mar 25, 2022; 11(2): 111-112
Published online Mar 25, 2022. doi: 10.5501/wjv.v11.i2.111
Novel appearance of hyperglycemia/diabetes, associated with COVID-19
Ioannis Ilias, Department of Endocrinology, Diabetes & Metabolism, Elena Venizelou Hospital, Athens GR-11521, Greece
ORCID number: Ioannis Ilias (0000-0001-5718-7441).
Author contributions: Ilias Ι conceived and wrote this letter.
Conflict-of-interest statement: The author declares no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ioannis Ilias, MD, PhD, Consultant Physician-Scientist, Department of Endocrinology, Diabetes & Metabolism, Elena Venizelou Hospital, 2 Elena Venizelou Sq., Athens GR-11521, Greece. iiliasmd@yahoo.com
Received: September 29, 2021
Peer-review started: September 29, 2021
First decision: January 12, 2022
Revised: January 12, 2022
Accepted: March 15, 2022
Article in press: March 15, 2022
Published online: March 25, 2022
Processing time: 173 Days and 15.3 Hours

Abstract

In a recent meta-analysis the prevalence of coronavirus disease 2019 (COVID-19)-associated hyperglycemia was 25%, and that of COVID-19-associated new-onset diabetes was 19%. An association between hyperglycemia or new-onset diabetes and COVID-19 has been suggested. In a recent relevant study of critically and non-critically ill patients with COVID-19, we found that indeed beta-cell function was compromised in critically ill patients with COVID-19 and that these patients showed a high glycemic gap. Nevertheless, one quarter of critically ill patients with no history of diabetes have stress hyperglycemia, a finding which could obscure the prevalence of hyperglycemia or new-onset diabetes that could be attributed to COVID-19 per se.

Key Words: Blood glucose; Pandemics; Severe acute respiratory syndrome coronavirus 2; Humans; Hyperglycemia; Hospitalization

Core Tip: An association between hyperglycemia or new-onset diabetes and coronavirus disease 2019 (COVID-19) has been suggested. Nevertheless, one quarter of critically ill patients with no history of diabetes have stress hyperglycemia, a finding which could obscure the prevalence of hyperglycemia or new-onset diabetes that could be attributed to COVID-19 per se.
TO THE EDITOR

We have read with great interest the work by Shrestha et al[1] regarding new-onset hyperglycemia/ diabetes (DM) in patients with coronavirus disease 2019 (COVID-19). With an erudite meta-analysis the authors found that the pooled prevalence of COVID-19-associated hyperglycemia was 25.23% and that the prevalence of COVID-19-associated new-onset DM was 19.70%[1].

An association between hyperglycemia/new-onset DM and COVID-19 has been suggested[2], via decreased insulin secretion and increased insulin resistance[2,3]. In a recent relevant study, of critically and non-critically ill patients with COVID-19, we found that indeed beta cell function (based on glucose and insulin measurements and using the Homeostasis Model Assessment HOMA2 estimate of steady state beta cell function[4]) was compromised in critically ill patients with COVID-19. Furthermore, these patients showed a high glycemic gap (based on admission glucose and glycated hemoglobin measurements)[5]. Nevertheless, we acknowledged that on average, 25% of critically ill patients with no history of DM have stress hyperglycemia[5-7], a finding which could obscure the prevalence of hyperglycemia/new-onset DM that could be attributed to COVID-19 per se.

Thus, it would be interesting if the results of the study by Shrestha et al[1] were presented separately-if possible-for critically and non-critically ill patients with COVID-19 and compared to non-COVID-19 patients.

Footnotes

Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Virology

Country/Territory of origin: Greece

Peer-review report’s scientific quality classification

Grade A (Excellent): A

Grade B (Very good): B

Grade C (Good): C

Grade D (Fair): D

Grade E (Poor): 0

P-Reviewer: Gonzalez FM, Chile; Gupta S, United States; Wang TJ, China S-Editor: Fan JR L-Editor: A P-Editor: Fan JR

References
1.  Shrestha DB, Budhathoki P, Raut S, Adhikari S, Ghimire P, Thapaliya S, Rabaan AA, Karki BJ. New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis. World J Virol. 2021;10:275-287.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 39]  [Cited by in F6Publishing: 32]  [Article Influence: 10.7]  [Reference Citation Analysis (5)]
2.  Muniangi-Muhitu H, Akalestou E, Salem V, Misra S, Oliver NS, Rutter GA. Covid-19 and Diabetes: A Complex Bidirectional Relationship. Front Endocrinol (Lausanne). 2020;11:582936.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 62]  [Cited by in F6Publishing: 49]  [Article Influence: 12.3]  [Reference Citation Analysis (2)]
3.  Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021;17:11-30.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 671]  [Cited by in F6Publishing: 552]  [Article Influence: 184.0]  [Reference Citation Analysis (0)]
4.  Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27:1487-1495.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 3281]  [Cited by in F6Publishing: 3592]  [Article Influence: 179.6]  [Reference Citation Analysis (0)]
5.  Ilias I, Diamantopoulos A, Pratikaki M, Botoula E, Jahaj E, Athanasiou N, Tsipilis S, Zacharis A, Vassiliou AG, Vassiliadi DA, Kotanidou A, Tsagarakis S, Dimopoulou I. Glycemia, Beta-Cell Function and Sensitivity to Insulin in Mildly to Critically Ill Covid-19 Patients. Medicina (Kaunas). 2021;57.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 13]  [Cited by in F6Publishing: 29]  [Article Influence: 9.7]  [Reference Citation Analysis (0)]
6.  Bellaver P, Schaeffer AF, Dullius DP, Viana MV, Leitão CB, Rech TH. Association of multiple glycemic parameters at intensive care unit admission with mortality and clinical outcomes in critically ill patients. Sci Rep. 2019;9:18498.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 20]  [Cited by in F6Publishing: 41]  [Article Influence: 8.2]  [Reference Citation Analysis (0)]
7.  Ali Abdelhamid Y, Kar P, Finnis ME, Phillips LK, Plummer MP, Shaw JE, Horowitz M, Deane AM. Stress hyperglycaemia in critically ill patients and the subsequent risk of diabetes: a systematic review and meta-analysis. Crit Care. 2016;20:301.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 49]  [Cited by in F6Publishing: 67]  [Article Influence: 8.4]  [Reference Citation Analysis (0)]