The prognostic significance of insulin resistance in COVID-19: a review

Esmaeil Mehraeen; Faeze Abbaspour; Maciej Banach; SeyedAhmad SeyedAlinaghi; Ameneh Zarebidoki; Seyed Saeed Tamehri Zadeh

doi:10.1007/s40200-024-01385-8

The prognostic significance of insulin resistance in COVID-19: a review

J Diabetes Metab Disord. 2024 Jan 20;23(1):305-322. doi: 10.1007/s40200-024-01385-8. eCollection 2024 Jun.

Authors

Esmaeil Mehraeen¹, Faeze Abbaspour², Maciej Banach³, SeyedAhmad SeyedAlinaghi⁴, Ameneh Zarebidoki⁵, Seyed Saeed Tamehri Zadeh⁶

Affiliations

¹ Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.
² School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 93338 Lodz, Poland.
⁴ Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
⁵ School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁶ Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, Velenjak, P.O. Box 19395-4763, Tehran, Iran.

PMID: 38932824
PMCID: PMC11196450 (available on 2025-01-20)
DOI: 10.1007/s40200-024-01385-8

Abstract

Objectives: Emerging publications indicate that diabetes predisposes patients with COVID-19 to more severe complications, which is partly attributed to inflammatory condition. In the current review, we reviewed recent published literature to provide evidence on the role of insulin resistance (IR) in diabetes, the association between diabetes and COVID-19 severity and mortality, the impact of COVID-19 infection on incident new-onset diabetes, mechanisms responsible for IR in COVID-19 patients, and the predictive value of different surrogates of IR in COVID-19.

Method: The literature search performs to find out studies that have assessed the association between IR surrogates and morbidity and mortality in patients with COVID-19.

Results: We showed that there is a bulk of evidence in support of the fact that diabetes is a potent risk factor for enhanced morbidity and mortality in COVID-19 patients. COVID-19 patients with diabetes are more prone to remarkable dysglycemia compared to those without diabetes, which is associated with an unfavourable prognosis. Furthermore, SARS-COV2 can make patients predispose to IR and diabetes via activating ISR, affecting RAAS signaling pathway, provoking inflammation, and changing the expression of PPARɣ and SREBP-1. Additionally, higher IR is associated with increased morbidity and mortality in COVID-19 patients and different surrogates of IR can be utilized as a prognostic biomarker for COVID-19 patients.

Conclusion: Different surrogates of IR can be utilized as predictors of COVID-19 complications and death.

Keywords: COVID-19; Diabetes; Dysglycemia; Insulin resistance; SARS-COV2.

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Publication types

Review