Diabetes and severe COVID-19 infection: Connecting the dots.

Diabetes is a significant risk factor for coronavirus disease 2019 (COVID-19) severity, poor prognosis, and mortality. Uncontrolled hyperglycaemia is associated with impaired innate and adaptive immunity predisposing to severe infection. In addition, there are other mechanisms linked to diabetes such as the upregulation of angiotensin-converting enzyme-2 receptor that might aid in viral entry and spread. The chronic low-grade inflammation and endothelial dysfunction might provide the backdrop to the development of cytokine storm and thromboembolic complications. Understanding the pathophysiology behind severe COVID-19 in diabetes will help to optimise management.