King's College London

Research portal

COVID-19 and metabolic disease: mechanisms and clinical management

Research output: Contribution to journalArticlepeer-review

Charlotte Steenblock, Peter E H Schwarz, Barbara Ludwig, Andreas Linkermann, Paul Zimmet, Konstantin Kulebyakin, Vsevolod A Tkachuk, Alexander G Markov, Hendrik Lehnert, Martin Hrabě de Angelis, Hannes Rietzsch, Roman N Rodionov, Kamlesh Khunti, David Hopkins, Andreas L Birkenfeld, Bernhard Boehm, Richard I G Holt, Jay S Skyler, J Hans DeVries, Eric Renard & 16 more Robert H Eckel, K George M M Alberti, Bruno Geloneze, Juliana C Chan, Jean Claude Mbanya, Henry C Onyegbutulem, Ambady Ramachandran, Abdul Basit, Mohamed Hassanein, Gavin Bewick, Giatgen A Spinas, Felix Beuschlein, Rüdiger Landgraf, Francesco Rubino, Geltrude Mingrone, Stefan R Bornstein

Original languageEnglish
Pages (from-to)786-798
Number of pages13
JournalThe Lancet Diabetes and Endocrinology
Issue number11
Early online date4 Oct 2021
E-pub ahead of print4 Oct 2021
PublishedNov 2021

Bibliographical note

Funding Information: KK reports acting as a consultant or speaker, or receiving grants for investigator-initiated studies for AstraZeneca, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly and Merck Sharp & Dohme, Boehringer Ingelheim, Bayer, Berlin-Chemie AG–Menarini Group, Janssen, and Napp. JSS reports personal fees as a consultant or advisor for Abvance, Adocia, Astra-Zeneca, Avotres, Bayer, Biozeus, Boehringer-Ingelheim, Dalcor, Dance Biopharm–Aerami Therapeutics, Diavacs, Duologics, Elcelyx, Eli Lilly, Enthera, Esperion, Geneuro, Ideal Life, Imcyse, Immunomolecular Therapeutics, Intarcia, Kamada, Kriya, Moerae Matrix, Novo-Nordisk, Oramed, Orgenesis, Pila Pharma, Precigen ActoBiotics, Preziba/Signos, Provention Bio, Sanofi, Tolerion, Valeritas, Viacyte, Viela Bio, vTv Therapeutics, and Zafgen. JHDV reports personal fees as consultant or advisor for Adocia, Novo Nordisk, and Zealand. ER reports personal fees as consultant or advisor for Abbott, Air Liquide, AstraZeneca, Boehringer-Ingelheim, Cellnovo, Dexcom, Eli Lilly, Insulet, Johnson & Johnson (Animas, LifeScan), Medirio, Medtronic, Novo Nordisk, Roche Diagnostics, Sanofi-Aventis, and Tandem; and research grant or material support from Abbott, Dexcom, Insulet, Roche Diagnostics, and Tandem. BG reports personal fees as consultant or advisor for Novo Nordisk, Pfizer, Merck Sharp & Dohme, Astra Zeneca, and Takeda. FR reports personal fees as a consultant or advisor for Ethicon, Medtronic, and Novo Nordisk. All other authors declare no competing interests. Funding Information: The work of CS, AL, BL, and SRB is partly supported by grants from the Deutsche Forschungsgemeinschaft, a German Research foundation (project number 314061271 and 288034826). AL is supported by an additional grant from DFG (project number 324141047). Publisher Copyright: © 2021 Elsevier Ltd

King's Authors


Up to 50% of the people who have died from COVID-19 had metabolic and vascular disorders. Notably, there are many direct links between COVID-19 and the metabolic and endocrine systems. Thus, not only are patients with metabolic dysfunction (eg, obesity, hypertension, non-alcoholic fatty liver disease, and diabetes) at an increased risk of developing severe COVID-19 but also infection with SARS-CoV-2 might lead to new-onset diabetes or aggravation of pre-existing metabolic disorders. In this Review, we provide an update on the mechanisms of how metabolic and endocrine disorders might predispose patients to develop severe COVID-19. Additionally, we update the practical recommendations and management of patients with COVID-19 and post-pandemic. Furthermore, we summarise new treatment options for patients with both COVID-19 and diabetes, and highlight current challenges in clinical management.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454