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Shared pathways for COVID-19 and diabetes?

EASD 2020
The idea that COVID-19 and diabetes have shared pathways stems from the fact that medications used to treat diabetes often include agents that modulate the expression and activity of angiotensin converting enzyme 2 (ACE2), a key player in SARS-CoV-2 infectivity. Despite new insights, the effects of possible shared pathways remain unclear [1]. ACE2 is the principal receptor through which SARS-CoV-2 enters cells, and the cellular protease, TMPRSS2, enables this entry through priming of the spike protein. In addition, no entry of SARS-CoV-2 has been observed in the absence of dipeptidyl peptidase-4 (DPP-4), as DPP-4 is permissive for entry of the virus. Regarding DDP-4 inhibitors, there is no clear evidence in patients with COVID-19 and type 2 diabetes that these agents are beneficial. Data has shown that they can reduce inflammation, but a recent analysis of the TECOS trial in which patients were treated with sitagliptin, showed no change in the inflammatory...

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