Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2.

TitleHyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2.
Publication TypeJournal Article
Year of Publication2021
AuthorsReiterer, M, Rajan, M, Gómez-Banoy, N, Lau, JD, Gomez-Escobar, LG, Ma, L, Gilani, A, Alvarez-Mulett, S, Sholle, ET, Chandar, V, Bram, Y, Hoffman, K, Bhardwaj, P, Piloco, P, Rubio-Navarro, A, Uhl, S, Carrau, L, Houhgton, S, Redmond, D, Shukla, AP, Goyal, P, Brown, KA, tenOever, BR, Alonso, LC, Schwartz, RE, Schenck, EJ, Safford, MM, Lo, JC
JournalCell Metab
Date Published2021 Sep 16
ISSN1932-7420
Abstract

Individuals infected with SARS-CoV-2 who also display hyperglycemia suffer from longer hospital stays, higher risk of developing acute respiratory distress syndrome (ARDS), and increased mortality. Nevertheless, the pathophysiological mechanism of hyperglycemia in COVID-19 remains poorly characterized. Here, we show that hyperglycemia is similarly prevalent among patients with ARDS independent of COVID-19 status. Yet among patients with ARDS and COVID-19, insulin resistance is the prevalent cause of hyperglycemia, independent of glucocorticoid treatment, which is unlike patients with ARDS but without COVID-19, where pancreatic beta cell failure predominates. A screen of glucoregulatory hormones revealed lower levels of adiponectin in patients with COVID-19. Hamsters infected with SARS-CoV-2 demonstrated a strong antiviral gene expression program in the adipose tissue and diminished expression of adiponectin. Moreover, we show that SARS-CoV-2 can infect adipocytes. Together these data suggest that SARS-CoV-2 may trigger adipose tissue dysfunction to drive insulin resistance and adverse outcomes in acute COVID-19.

DOI10.1016/j.cmet.2021.09.009
Alternate JournalCell Metab
PubMed ID34599884
PubMed Central IDPMC8443335
Grant ListR01 DK121140 / DK / NIDDK NIH HHS / United States
R01 CA234614 / CA / NCI NIH HHS / United States
R01 DK121844 / DK / NIDDK NIH HHS / United States
R01 DK121072 / DK / NIDDK NIH HHS / United States
R01 AI107301 / AI / NIAID NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
R01 CA215797 / CA / NCI NIH HHS / United States