Abstract

Background: Corona virus 2019 (COVID-19) disease is a globally infectious disease caused by Severe Acute Respiratory Syndrome-Coronavirus-2 that is emerging and rapidly spreading. Diabetes is considered as one of the main contributing factors of high morbidity and mortality rates globally, where, uncontrolled diabetes is associated with macro- and micro-vascular complications affecting patient’s health wellbeing and survival. Concerning therapeutic protocols and treatment, several selected repurposed drugs are used in the management of COVID-19 infection as there is no approved effective vaccine till the moment, therefore, concerns might raise about potential drug interactions between drugs used in management of both COVID-19 and diabetes.

Results: About 42.3% of COVID-19 mortalities were diabetic patients, death rates were significantly higher in hospitalized type 2 diabetic patients than non-diabetic ones and were more susceptible to acute respiratory distress syndrome and other life threatening complications. Most antiviral agents are CYP450 inhibitors or inducers or CYP450 substrates, thus, drug interactions might occur with CYP450 substrates as thiazolidinediones, sulfonylureas, and short-acting secretagogues used in the management of diabetes. Besides, chloroquine and hydroxychloroquine cause hypoglycemia and prolonged QTc which should be taken in consideration upon management of diabetic COVID-19 patients.

Conclusion: Diabetic patients are more susceptible to severity and incidence of COVID-19, antidiabetic agents may interact with antiviral drugs and other therapeutic agents used in management of COVID-19, thus, caution should be taken in consideration upon selection of drug treatment to avoid undesirable potential adverse events or lack of therapeutic efficacy.

Keywords: COVID-19; Diabetic Patients; Drug Interactions; CYP3A4; Chloroquine; Hydroxychloroquine

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Citation

Citation: Nagwa A Sabri., et al. “Management Protocols Deviation of COVID-19 in Diabetic Patients. Is it Applicable?". Acta Scientific Pharmaceutical Sciences 5.2 (2021): 57-66.

Copyright

Copyright: © 2021 Nagwa A Sabri., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.