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Covid-19, Malaria, Diabetes, Obesity and Eosinophils

February 8, 2021 - 15:44 -- Pierre Lutgen

An increased number of scientific papers confirm that diabetes causes an increased risk in the mortality and severity of COVID-19. However, the mechanism is not entirely clear. Understanding the relationship between COVID-19 and diabetes could advance therapeutic measures, but there is a scarcity of data on the matter.

Gina Dube, an advanced practice clinical pharmacist at Brigham and Women’s Hospital in Boston, Massachusetts suggests that impaired immune systems make individuals with diabetes more susceptible to severe infections.

In our weblog on www.malariaworld.org « Malaria inhibits Covid » June 10, 2020 we suggested that immunoglobilin E might protect against Covid-19. In a more recent weblog « Eosinopenia, viral infections and Covid ». on Jan 14 2021 we propose that eosinophils might play a more important role.

A recent study, based on the retrospective analysis of the clinical record of 4252 hospitalized patients with a positive SARS-Cov-2 PCR test, found that a higher percentage of eosinophils was predictive of higher odds of survival.

Glickman, J.W., Pavel, A.B., Guttman‐Yassky, E. and Miller, R.L. (2021), The role of circulating eosinophils on COVID‐19 mortality varies by race/ethnicity. Allergy. https://doi.org/10.1111/all.14708

A recent study from India confirms that diabetes and eosinopenia are associated with severity of the Covid disease. Eosinophils are 4 times lower in severe cases.

Anurag A, Jha PK, Kumar A. Differential white blood cell count in the COVID-19: A cross-sectional study of 148 patients. Diabetes Metab Syndr. 2020;14(6):2099-2102. doi:10.1016/j.dsx.2020.10.029
Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, Qin R, Wang H, Shen Y, Du K, Zhao L, Fan H, Luo S, Hu D. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020 Mar 31: e3319. doi: 10.1002/dmrr.3319.

Eosinophils, a specific type of immune cell, may present as a new target for the treatment of Type 2 diabetes mellitus and obesity-related hypertension. A collaborative study conducted by researchers at Lund University, Sweden; University of Manchester; and University of Salford, Manchester, UK discovered that the number of eosinophils was greatly reduced in specific tissue layers of obese mice.

This study was the first to identify a correlation between a reduction in eosinophil count within obese mice. This reduced function contributed to the development of Type 2 diabetes mellitus and obesity-related hypertension. Lead researcher, Dr Sheena Cruickshank, University of Manchester, Manchester, UK commented on the findings, explaining: “Our study showed that in fact the secretions from eosinophils have a profound effect on how the blood vessels operate when they are missing, as in obesity, serious health problems can start to develop.” Cruickshank added, “These immune cells have been traditionally overlooked, but this study shows for the first time that they have a direct role to play in processes in the body beyond the immune system.”

A Chinese cross-sectional study found that higher peripheral eosinophil percentage was independently associated with decreased risk of T2D and insulin resistance in middle aged and elderly Chinese. Insulin resistance played an important intermediate role in the association between eosinophil and impaired glucose metabolism. The study was performed among 9 111 Chinese adults

Zhu L, Su T, Xu M, Xu Y, Li M, et al. (2013) Eosinophil Inversely Associates with Type 2 Diabetes and Insulin Resistance in Chinese Adults. PLoS ONE 8(7)

A Californian study also showed that eosinophilia enhances glucose tolerance. Their results suggest that eosinophils play an unexpected role in metabolic homeostasis . Mice fed a high-fat diet develop increased body fat, impaired glucose tolerance, and insulin resistance in the absence of eosinophils.

Wu D, Molofsky AB, Liang HE, Ricardo-Gonzalez RR, Jouihan HA, Bando JK, Chawla A, Locksley RM. Eosinophils sustain adipose alternatively activated macrophages associated with glucose homeostasis. Science. 2011 Apr 8;332(6026):243-7.
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Comments

Submitted by Pierre Lutgen on

Surprised to find this Tweeter from @AstraZeneca· 7 feb
« Backed by a growing body of evidence, we’re committed to advancing our understanding of the role of EOSINOPHILS in inflammatory diseases with the aim to improve diagnosis, patient referrals and timely, appropriate care ».

Suddenly they show interest in eosinophils. Did they read the following blogs on www.malariaworld.org: « Covid-19, Malaria, Diabetes, Obesity and Eosinophils », » Covid, deworming, malaria, eosinopenia… ».

It is probably a reaction to the fact that South Africa halted use of the AstraZeneca-Oxford coronavirus vaccine on February 6 after evidence emerged that the vaccine did not protect clinical trial volunteers from mild or moderate illness caused by new variant. French president Emmanuel Macron recently claimed the Oxford vaccine was “quasi-ineffective”.

Exactly a year ago, on 11 February 2020, research teams led by Professor Andy Pollard and Professor Sarah Gilbert – both based at the Oxford Vaccine Centre – decided to combine their talents to develop and manufacture a vaccine that could protect people from the deadly new coronavirus that was beginning to spread across the world. (The Guardian Feb 14, 20121). One may wonder why they started developing a vaccine against Covid in February 2021, when barely anybody had heard about this new flue.

Of course some vacccines work and have saved many lifes.

But all attempts to develop a vaccine against malaria so far have failed. Some people also are afraid that the development of a vaccine against the coronavirus will be a difficult task and the use of the Africans as guinea pigs is resented by many.
(see on www.malariaworld.org the blog : RTS,S vaccine: an African medical doctor raises the alarm)