The devastating pandemic of coronavirus disease 2019 (COVID-19) has caused thousands of deaths and left millions of restless patients suffering from its complications. Increasing data indicate that the disease presents in a severe form in patients with pre-existing chronic conditions like cardiovascular diseases, diabetes, respiratory system diseases, and renal diseases. This denotes that these patients are more susceptible to COVID-19 and have higher mortality rates compared to patients with no comorbid conditions. Several factors can explain the heightened susceptibility and fatal presentation of COVID-19 in these patients, for example, the enhanced expression of the angiotensin-converting enzyme-2 (ACE2) in specific organs, cytokine storm, and drug interactions contribute to the increased morbidity and mortality. Adding to the findings that individuals with pre-existing conditions may be more susceptible to COVID-19, it has also been shown that COVID-19 can induce chronic diseases in previously healthy patients. Therefore, understanding the interlinked relationship between COVID-19 and chronic diseases helps in optimizing the management of susceptible patients. This review comprehensively described the molecular mechanisms that contribute to worse COVID-19 prognosis in patients with pre-existing comorbidities such as diabetes, cardiovascular diseases, respiratory diseases, gastrointestinal and renal diseases, blood disorders, autoimmune diseases, and finally, obesity. It also focused on how COVID-19 could, in some cases, lead to chronic conditions as a result of long-term multi-organ damage. Lastly, this work carefully discussed the tailored management plans for each specific patient population, aiming to achieve the best therapeutic outcome with minimum complications. Graphical abstract Unlabelled Image Highlights • Chronic diseases patients are at increased risk for severe COVID-19 manifestations • COVID-19 affects many organs through ACE-2 receptor • COVID-19 induces multi-organ damage in individuals with no preexisting comorbidities • The mechanism of COVID-19-induced multiorgan damage is essential • Tailoring therapy protocols for chronic diseases in COVID-19 patients is highly needed
【저자키워드】 COVID-19, Prognosis, COVID-19, Coronavirus disease 2019, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, CLL, Chronic lymphocytic leukemia, ACE2, Angiotensin-converting enzyme-2, COPD, Chronic obstructive pulmonary disease, SARS-CoV, severe acute respiratory syndrome coronavirus, MERS-CoV, Middle East respiratory syndrome coronavirus, ARDS, acute respiratory distress syndrome, IL, interleukin, WHO, World Health Organization, Multi-organ damage, BMI, Body mass index, ICU, Intensive care unit, GI, gastrointestinal, AST, aspartate aminotransferase, DIC, disseminated intravascular coagulation, AKI, acute kidney injury, Ang II, Angiotensin II, RAS, Renin-angiotensin system, IBD, Inflammatory bowel disease, TMPRSS2, Transmembrane Protease Serine 2, chronic disorders, TH1, T-helper-1, iCS, Inhaled corticosteroids, Management plans, CFR, case-fatality rate, DKA, diabetic ketoacidosis, SGLT-2, sodium-glucose-co-transporter 2, Th2, T-helper 2, IgE, immunoglobin E, NF- κB, nuclear factor kappa B, ATN, acute tubular necrosis, SCD, sickle cell disease, ACS, acute chest syndrome,