Ukr.Biochem.J. 2023; Volume 95, Issue 2, Mar-Apr, pp. 5-23
doi: https://doi.org/10.15407/ubj95.02.005
Immunological mechanisms of increased susceptibility to COVID-19 disease and its severe course in patients with diabetes mellitus type 2 and obesity
K. P. Zak1, M. D. Tronko1, S. V. Komisarenko2*
1V. P. Komisarenko Institute of Endocrinology and Metabolism,
National Academy of Medical Sciences of Ukraine, Kyiv;
2Palladin Institute of Biochemistry, National Academy of Sciences of Ukraine, Kyiv;
*e-mail: svk@biochem.kiev.ua
Received: 28 April 2023; Revised: 28 May 2023;
Accepted: 05 June 2023; Available on-line: 20 June 2023
In this review, we analyze and summarize literature data and the results of our own research related to the immunity status of patients with type 2 diabetes mellitus (T2D) and those T2D patients who were infected with the SARS-CoV-2 virus. It was shown that in the blood plasma of T2D patients, especially those with elevated BMI, the level and ultrastructure of the main cellular components of natural immunity – neutrophils and monocytes – were affected accompanied by high levels of proinflammatory cytokines (IL-1β, IL-6, IL-17 and TNF-α). It was suggested that the increased susceptibility of T2D patients to SARS-CoV-2 infection is primarily due to a weakening of the innate immune defense against pathogens, whereas in T2D patients who have COVID-19, adaptive T-cell immunity disorders accompanied by a cytokine storm prevail. It was concluded that hyperinflammation in T2D+COVID19 patients is the result of enhancement of already existing before SARS-CoV-2 infection T2D-caused disorders of innate and adaptive immunity, in the mechanism of which cytokines and chemokines play a significant role.
Keywords: COVID-19, cytokines, innate and adaptive immunit, neutrophils, T-lymphocytes, type 2 diabetes mellitus
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