Abstract
SARS-COV-2 is the novel type of beta coronavirus that was first evolved in December
2019 in Wuhan, China. People with type 2 diabetes are the most vulnerable group to SARS-COV-2
and its associated complications. Many factors such as medication, pathophysiologic-induced compensatory
mechanisms, and alterations in protein expression and immune system function can all
contribute to severe outcomes in diabetics. In this review article, we first described the possible
mechanisms of increased risk and more severe complications rate of SARS-COV-2 in diabetic patients.
Secondly, we discussed the crucial role of exercise in diabetic patients in balancing the RAS
system (ACE2/ACE). Finally, we examine the possible roles of acute and chronic exercise in reducing
SARS-COV-2 severe outcomes in people with diabetes in accordance with the latest evidence.
We concluded that regular exercise (especially moderate-intensity exercise) can play a role in immune-
enhancing, anti-inflammatory, and anti-oxidant activities and can balance the ACE2/ACE ratio
(decreasing ANG2 levels) in diabetic subjects.
Keywords:
SARS-COV-2, diabetes, angiotensin-converting enzyme inhibitors, beta-blockers, exercise, angiotensin-converting enzyme 2, angiotensin II, health.
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