Diabetes care during the outbreak of 2019 novel coronavirus disease (COVID-19) in Taiwan

摘要

Coronavirus disease 2019 (COVID-19) is now a global pandemic which is imposing a heavy burden on medical resources. The total number of reported COVID-19 cases as of April 16, 2020 is more than 2.07 million with 137 666 deaths worldwide, including a total of 395 cases and 6 deaths in Taiwan. 1 The first fatal case of COVID-19 in Taiwan occurred on February 16, 2020, and was a taxi driver with no history of travel who was infected by a passenger who had just arrived back from Wuhan, China. This case raised the concerns of cli- nicians about a higher risk of severe complications and mortality in patients with diabetes mellitus. 2 Patients with diabetes are considered to be at high risk of acquired infections, possibly due to poor glucose control. In addition, patients with diabetes have an impaired immune- response to infection both in relation to changes in cytokine profile, T-cell and macrophage activation. Hyperglycemia reduces chemotaxis and the activation of polymorphonuclear neutrophils, and thus dia- betic patients have higher rates of morbidity and mortality due to infections. In addition, most patients with diabetes develop co-morbidities over time, including hypertension, dyslipidemia, obesity and cardiovascular disease. The number of comorbidities is a predictor of mortality in patients with COVID-19.