Chronic Degenerative Diseases Before and After the COVID-19 Pandemic in Mexico

Lifestyle choices are of the utmost importance when discussing
disease prevention and treatment. Time and again, doctors...


Metabolic Diseases in Mexico
5-15 years ago, in Mexico, Diabetes Mellitus (DM) was the primary cause of death for 33% of women and 26% of men. The WHO said that more than 50% of deaths worldwide were due to chronic illness and that, this percentage would increase by 17% in the next 10 years, this has already come true [2]. From a sociocultural perspective, there are inherent aspects of these factors that cause significant problems. The "normal" diet in the Mexican population is taught from prior generations and has several economic and political factors that surround it. In this manner, nutritional habits are a reflection of our surroundings. Mexico has a cultural and social tendency towards high caloric diets, with simple carbohydrates and saturated fats, which has led to a genetic predisposition for degenerative chronic illness in the population, based on malnutrition. This includes the whole spectrum, from undernutrition to overweight and obesity [3]. this is a way to detect those cases with a normal weight obesity.
These children are at risk for chronic degenerative diseases in adulthood [5]. These statistics come with economic consequences as well, recent estimations calculate that approximately 73-87% of the planned health budget is going towards these health issues only in public health institutions [6].

Government Efforts
In the last decade, the Mexican government has made several

COVID-19 and Chronic Degenerative Diseases
Persistent inflammation is a high-risk factor for chronic degenerative diseases. Obesity and diabetes are key triggers for said inflammation, by promoting the constant release of proinflammatory cytokines such as IL-1, IL-6 and TNF-α [12]. With obesity, there is also a decrease in the anti-inflammatory stimuli like adiponectin, which in turn activates endothelial dysfunction by decreasing nitric oxide and elevated levels of reactive oxygen species [13]. COVID-19, an infectious disease caused by coronavirus infection, can originate -in some patients-a cytokine storm that involves pro-inflammatory cytokines and can lead to multi-organ failure [14]. One hypothesis is that this is brought on by postprandial glycemic spikes that increase immune system activation (through the hexosamine pathway that leads to interferon regulatory factor-5 increasing cytokine production) [15]. This profile has been observed increasingly in critical patients. Studies from several countries have found that about 80% of critical patients in need of hospital care have at least one underlying chronic condition, of which the most common were overweight/obesity, hypertension, chronic lung disease, diabetes, and cardiovascular disease [16][17][18]. Furthermore, findings suggest that COVID-19 infection can cause direct damage to pancreatic β-cells by binding to pancreatic angiotensin-converting enzyme 2 (ACE2) receptors and thereby reducing insulin secretion, leading to hyperglycemia [15].
In short, the link between fatal COVID-19 cases and cardiometabolic comorbidities has been made, which implies a serious challenge in this pandemic, especially for a country like Mexico with the prevalence for this disease being so high [19].

What´s next?
Modulating the hyperinflammatory response to COVID-19 is a priority now, but the lesson we take from this experience should be permanent. for the chronic diseases they lead to but also the way they affect the body´s response to infectious diseases as well.

Disclosure statement
The authors declare that there are no potential conflicts of interest.