Old age, diabetes, immune system and COVID-19
A significant deaths have been reported in comorbid condition particularly in old age patients with metabolic disease and its complications such as hypertension because this creates a low cytosolic pH condition, which is a favorable state for SARS-CoV-2 virus for binding to its ACE 2 receptor and enhances the virus transmission (Arachchillage & Laffan, 2020). Further, diabetes is associated with low-grade inflammation with systemic release of cytokines, thrombotic events and this can lead to rapid deterioration of patients of COVID-19 due to the additive burden of cytokine storm and may increase the mortality in co-morbidity (Randeria, Thomson, Nell, Roberts & Pretorius, 2019). There is global diversity in severity and mortality among COVID-19 patients because of the diverse ethnic, geographical and immune system of patients. The immune system is one of the major contributing factors for increased mortality rate in COVID-19 patients because there is a suppression of the immune system due to chronic diabetes, cancer, immunosuppressant therapy, corticosteroids and aging which making patients more prone towards SARS-CoV-2 infection and may increase the co-morbidity and mortality rate (Bornstein et al., 2020; Ferlita et al., 2019).