New-onset diabetes in COVID-19 The molecular pathogenesis

Diabetes mellitus (DM) is still a challenging metabolic disease worldwide. In the current situation, the world is facing a COVID-19 pandemic due to SARS-CoV-2 infection. DM is one of comorbid that can worsen the severity of the COVID-19 condition. Surprisingly, SARS-CoV-2 infection can induce new-onset diabetes, a condition in which acute hyperglycemia occurs and may potentially develop into a complication in non-diabetic patients. Angiotensin-converting enzyme 2 (ACE2) is a crucial entry factor of SARS-CoV-2 infection. ACE2 will bind to the spike protein of SARS-CoV-2, making its entrance to the potentially damaging process of many tissues in the human body, including that of metabolic tissues. This mechanism suggests a potential role of ACE2 in the pathogenesis of diabetes since ACE2 has been proven to localize in essential metabolic tissues, one of which is the acini and islets part of the pancreas. This interrelated ACE2 in COVID-19 and DM is thought as the mechanism that induces new-onset diabetes in COVID-19 patients. This review will thoroughly describe the current findings and theories regarding the molecular mechanism of SARS-CoV-2induced new-onset diabetes and the possible therapeutic intervention.