Abstract
People with Diabetes show an increased susceptibility to infection by SARS-CoV-2, greater incidence of pneumonia, and worse clinical outcomes. As diabetes involves high glycative stress, here we present a review of the literature regarding the potential interactions of glycative stress and COVID-19 that may help to explain some of the observed differences in outcomes of diabetic patients. Glycative stress directly suppresses immune function, leaving the body less able to deal with infection. Increased colonization of potentially pathogenic bacteria, mediated by glycative stress, such as Staphylococcus aureus, may also lead to negative outcomes during infection. The presence of S. aureus on the skin may weaken its barrier function and increase the risk of infection through the skin. Proteolytic activity necessary for the virus to enter cells may be enhanced in tissue exposed to S. aureus as well as by the bacteria’s own secreted proteases. Finally, S. aureus carriage could be a risk factor for the development of secondary bacterial pneumonia during primary COVID-19 infection. In order to avoid infection and severe disease outcomes, it is important for those suspected of having diabetes to maintain strict glycemic control and take measures to avoid exposure to the virus.
