The fatal disease that originated from one of the most populated cities in China-Wuhan has now taken the lives of thousands of people across the globe. The center of outbreak of COVID-19 is said to be the seafood market present in the Wuhan city. The COVID-19 virus is potentially dangerous, as it can spread very quickly from one person to another. This disease was declared a global emergency by the WHO. There was an abrupt rise in the number of cases, and the disease became uncontrollable. It is a highly contagious virus that seized the entire world under its domain. At the time of initial spread, people didn’t notice the severity of disease; eventually, the WHO announced it as a pandemic.

Coronavirus is not a new class of viruses; the first discovery of this virus was long back ago. Several groups of this virus are known to be causing mild to moderate flu-like disease. This family includes the viruses causing Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The COVID-19 brought a new strain of coronavirus that has high epidemicity. The other virus belonging to this family has shown animal to human transmission. There is no such evidence of animal to human transmission in COVID-19, and the analysis is still on process.

Doctors have reported that people of all age groups can get infected by this virus. Older people and people with comorbid conditions like heart disease, diabetes, respiratory diseases, and hypertension are more prone to experience severe complications. Scientists are working strenuously to invent new vaccines every day to cope up with this serious condition. Different countries are trying to develop a vaccine, but none of them is universally accepted till now. Doctors are working hard 24 hours to manage the patients. Doctors are providing a different combination of anti-viral medicines to reduce the complication. Patients are coping arduously to fight this disease, staying away from their loved ones. None of the drugs can treat the disease completely; there is just a decrease in the symptoms of the disease.

After the doctors declared high risk for the patients with underlying medical conditions, the people suffering from diabetes and other comorbid conditions are panicking a lot. We are here to solve the common queries that people demand. Let us begin with the primary points associated with COVID-19 that everyone should be aware of:

1. Briefing about the history of the disease:

A 55-year-old lady was declared to be the first recognized case of coronavirus. Research articles state that this virus has an influential connection with the seafood market in the Hubei province of Wuhan. The ”zero case” was found in November 2019 in a seafood seller from Wuhan. After this, there was the detection of several cases in December. The animal origin of this virus remains a remarkable question because the sample taken from the animals in the seafood market came negative. The WHO confirmed the human to human transmission of this virus; but, there is no such assurance about the animal origin.

2. Was the first patient of COVID-19 comorbid?

The first patient or zero case of corona had no association with any underlying medical condition. She was a shrimp seller, and was doing alright before she developed common flu-like symptoms. She went to a local hospital, after a few days the condition worsened. She visited one of the biggest hospitals in Wuhan where she found out several other patients appeared with the same complaint & all of them had a history of visiting the seafood market. The first death of the coronavirus patient in China was said to have underlying medical conditions.

3. Common signs and symptoms in the patients?

The symptoms are the primary reason why a patient with any disease gets tested. Most of the initial cases of coronavirus were symptomatic. However, a few cases were entirely asymptomatic during the initial stages. The incubation period ranges from 5 to 14 days. The asymptomatic patient continued to be undiagnosed. A study stated that the asymptomatic and undiagnosed patient did a major contribution to the spread of the infection. Signs and symptoms mutual to both healthy and immunocompromised patient are as follows:

• Fever is the most common presentation of the coronavirus infection. The grade of fever varies in different people and age groups.
• Persistent cough is seen to be the second most common symptom in patients. The patients usually presented with a hacking cough. However, some of them also had sputum along with cough.
• It also had other manifestations such as loss of appetite, abdominal pain, nausea, vomiting, and diarrhea. Out of these, the loss of appetite is a major symptom.
• Other respiratory symptoms include shortness of breath, chest tightness, sneezing, runny nose, sore throat, and loss of smell.
• People also get generalized symptoms such as fatigue, body ache, skin lesions, and muscle and joint pain.
• The white blood count was normal or decreased in patients. They also had an increasing number of neutrophil count, creatinine, inflammatory serum markers, and blood urea.

4. Is diabetes a risk factor for COVID-19 patients?

Research has shown that most of the patients who visited the hospital with a severe state had diabetes. It is pretty obvious that patients who were healthy before infection receive mil flu-like symptoms. If the right treatment is provided, these patients will heal eventually. However, the patients having diabetes as a comorbid condition manifest more serious symptoms. Diabetes is the second most common high-risk factor associated with COVID-19 after the heart diseases. If someone has both diabetes and heart diseases, he/she must take appropriate precautions.

5. What are the factors that contribute to increased risk?

The patients suffering from diabetes have equal chances of acquiring this infection like other people. What makes it worse are the signs, symptoms, and the outcome of the disease. However, some older patients with diabetes are at high risk of acquiring coronavirus infection due to a weakened immune system. When a diabetic patient’s body encounters any foreign particle, there is an increased release of hyperglycemic hormones such as catecholamines and glucocorticoids. These hormones worsen the condition of a diabetic patient. On the other hand, the negative feedback mechanism induces hypoglycemia; it has a direct effect on the circulatory system. The older patients are more prone to develop a low lymphocytic level due to which the body fails to fight microbes. Hyperglycemia also contributes to the replication of the virus inside the body. It helps in the progress of infection that increases the chances of fatality.

6. What complications can a diabetic patient experience?

The coronavirus patients with pre-existing diabetes can show the following complications:

• Nerve damage can lead to demyelination of nerves. It leads to loss of sensation and memory depending upon the region of nerve damage. It can also cause irritability and mood disorders.
• Loss of skin barrier makes the skin more prone to lesions and the development of ulcers.
• If the circulatory imbalance remains uncontrolled, the patient can land up into shock or circulatory collapse.
• Multi-Organ Damage Syndrome
• More advanced respiratory conditions such as Acute Respiratory Distress Syndrome.
• Persistent hyperglycemic level despite taking insulin therapy.
• Ocular and renal manifestations are some other complications.

7. What are the warning signs that shouldn’t go unnoticed?

Warning signs should never go unnoticed. If you experience any of the following signs, immediately rush to the hospital:

• Chest tightening
• Shortness of breath or dyspnea.
• Increased fatigue and inability to move.
• Bluing of extremity, face, or lips (cyanosis).
• Highly abnormal blood pressure.
• Patient experiences anorexia and looks cachexia.

8. What is the risk of getting Diabetic Ketoacidosis?

Always keep the check of ketone levels in your blood. If you see any abnormal levels, please report to the hospital immediately. It can make it worse for people having complications like diarrhea and vomiting. Make sure to maintain the electrolyte balance of your body. Drink plenty of water in 24 hours. You can land into DKA, if there is an increased chance of other infections, sepsis, and electrolyte disturbances. Eating healthy and drinking adequate fluids restores the vital functions of your body that helps to delay the progression of disease.

9. Is it going to affect my insulin therapy?

Till now, none of the studies have affirmed the impact of COVID-19 infection in insulin therapy. Many prospective and retrospective studies are being carried to know more about this. Do not disturb the normal schedule of your insulin therapy.

10. What are the preventive measures & treatment modalities of a diabetic patient?

• Make sure to eat healthy food like vegetables, soups, and carbs.
• Avoid the carbs that can enhance the hyperglycemic state.
• Make sure to assemble all the medications in bulk to avoid going out and contacting people.
• Always keep the phone number of a healthcare worker or physician for emergencies.
• Isolate yourself from other members of the house. Make sure to use different utensils, clothes, towels, and maintain proper hygiene.
• Ask your family members to maintain hand hygiene and use masks.

11. How can COVID-19 impact me if I have diabetes along with other underlying conditions?

Depending on what condition you have, you can experience a wide variety of symptoms listed above in the sign, symptom, and complication column. Make sure to contact your doctor if you have more than one underlying medical comorbidities. It increases the chances of fatality.

We hope you are now fully acknowledged about the impact of the coronavirus on diabetic people. Thanks for reading. Stay healthy & safe!