Plenary Conference: Epidemiology during the storm: diabetes during the SARS-Cov-2 crisis
2020
Claudio González
The SARS-CoV-2 pandemic presents a considerable challenge to the health system and to epidemiological predictions all over the world. It is a viral infection caused by a positive-sense, single stranded RNA virus which has a lipid envelop in which proteins with different biological functions (proteins S, M and E) are embedded. The viral RNA codes the synthesis of the RNA polymerase (RdRP) and two proteases (C3CLpro and PLpro). The virus causes damage through direct mechanisms (inducing pyroptosis in certain tissues) and, in parts as a consequence, a series of indirect immune-inflammatory phenomena with the participation of different cytokines and other immune modulator molecules, and diverse cellular response. As a consequence, some patients experiment a dysregulated inflammatory response, which seems to be related with severe diseases and mortality. The presence of diabetes (at least, type 2 diabetes) seems to associate itself with a higher risk of severe morbidity and mortality. It is not clear whether people with diabetes are facing a higher risk of infection, but the presence of type 2 diabetes is associated to an increase in the relative risk of developing a severe disease, the admission to intensive care units and death, which ranges, in diverse studies, between a 50% and a 250% (OR: 1.50 a 3.5).
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