Management of Diabetes Complications During and After COVID-19

Introduction

COVID-19, the epidemic has begun to significantly affect the world's population. This newly recognized disease is caused by a novel coronavirus known as SARS-CoV-2. This virus is homologous to existing coronaviruses, like the Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV). It most commonly presents itself as an acute respiratory infection; nonetheless, it has the potential to impact several systems and can have far-reaching implications. SARS-CoV-2 infections can range from asymptomatic to respiratory disease, failure of more than one organ, and even death (Kingstone et al., 2020). Although the etiology, and problems of individuals with COVID-19 in the acute period, and demographic and clinical signs have been fully documented, the long-term repercussions of COVID-19 are mostly unexplained (Wiersinga et al., 2020).

In spring 2020, when COVID-19 sufferers were still experiencing signs weeks after their acute illness and shortly after the initial instances occurred, post-COVID syndrome, generally referred to as long-COVID, was first identified as a clinical entity. Post-COVID-19 illnesses are defined by the Centers for Disease Control and Prevention as any new, recurring, or persistent health issues that manifest themselves after the initial 4 weeks following COVID-19 infection. Long COVID (PCS) may be categorized into five groups based on symptom duration, the phase of quiescence, and the first onset of symptoms as depicted in Figure 1. Even in patients who had relatively minor bouts of acute sickness, the post-COVID syndrome manifests as a multi-system disorder (Greenhalgh, Knight, Buxton, & Husain, 2020). Even though there is some evidence to suggest that cytokines are behind the progression of post-COVID syndrome. Still further study is required to shed light on its pathophysiology (Alpert et al., 2020; Bhavana et al., 2020).

The body of evidence about the spectrum of post-COVID syndrome and the therapy of the condition is constantly growing, and this trend is expected to continue over the next several years. The symptoms of post-acute covid-19 may vary greatly. Even minor COVID-19 can cause long-term complications, most often coughing, chills, and exhaustion, which can reoccur and remit (Addison et al., 2021; Carfì, Bernabei, & Landi, 2020; C. Huang et al., 2021; Simani et al., 2021; Study, 2020). Other symptoms include chest discomfort, impairment in the senses of taste and smell, shortness of breath, migraines, neurocognitive problems, muscle aches and tiredness, gastrointestinal disturbance, rashes, metabolic disruption (such as poor diabetic management), thromboembolic disorders, stress, as well as other issues with mental health (Dasgupta et al., 2020). Skin rashes include vesicular, urticarial, maculopapular, as well as chilblain-like lesions (Casas, 2020). Post-infectious olfactory impairment, which may impact more than 60 percent of people with SARS-CoV-2 infection, including those with asymptomatic infections, is also a significant and frequent post-COVID syndrome symptom (Addison et al., 2021). Most post-COVID patients have a pulmonary illness, diabetes, hypertension, cardiovascular disease, and obesity (Carfì et al., 2020; C. Huang et al., 2021; Liang et al., 2020). Approximately 35% and 26% of individuals experiencing ongoing post-COVID signs reported hypertension and diabetes mellitus, respectively, while 16% and 9% had a cardiovascular and pulmonary illness (Carfì et al., 2020; C. Huang et al., 2021; Simani et al., 2021). Even though there is not a lot of proof right now, it is believed that the majority of patients who have post-COVID syndrome will be able to recover with a comprehensive strategy that is centered on primary healthcare (Greenhalgh et al., 2020).