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dc.contributor.authorMuniangi-Muhitu, Hermineen_US
dc.contributor.authorAkalestou, Elinaen_US
dc.contributor.authorSalem, Victoriaen_US
dc.contributor.authorMisra, Shivanien_US
dc.contributor.authorOliver, Nicholas S.en_US
dc.contributor.authorRutter, Guy A.en_US
dc.identifier.citationMuniangi-Muhitu, H., Akalestou, E., Salem, V., Misra, S., Oliver, N. S., & Rutter, G. A. (2020). Covid-19 and diabetes : a complex bidirectional relationship. Frontiers in Endocrinology, 11, 582936-. doi:10.3389/fendo.2020.582936en_US
dc.description.abstractCovid-19 is a recently-emerged infectious disease caused by the novel severe acute respiratory syndrome coronavirus SARS-CoV2. SARS-CoV2 differs from previous coronavirus infections (SARS and MERS) due to its high infectivity (reproduction value, R0, typically 2–4) and pre- or asymptomatic transmission, properties that have contributed to the current global Covid-19 pandemic. Identified risk factors for disease severity and death from SARS-Cov2 infection include older age, male sex, diabetes, obesity and hypertension. The reasons for these associations are still largely obscure. Evidence is also emerging that SARS-CoV2 infection exacerbates the underlying pathophysiology of hyperglycemia in people with diabetes. Here, we discuss potential mechanisms through which diabetes may affect the risk of more severe outcomes in Covid-19 and, additionally, how diabetic emergencies and longer term pathology may be aggravated by infection with the virus. We consider roles for the immune system, the observed phenomenon of microangiopathy in severe Covid-19 infection and the potential for direct viral toxicity on metabolically-relevant tissues including pancreatic beta cells and targets of insulin action.en_US
dc.relation.ispartofFrontiers in Endocrinologyen_US
dc.rights© 2020 Muniangi-Muhitu, Akalestou, Salem, Misra, Oliver and Rutter. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.en_US
dc.titleCovid-19 and diabetes : a complex bidirectional relationshipen_US
dc.typeJournal Articleen
dc.contributor.schoolLee Kong Chian School of Medicine (LKCMedicine)en_US
dc.description.versionPublished versionen_US
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