Abstract
Individuals with type 2 diabetes, hypertension and obesity havepoor outcomes from coronavirus-19 (COVID-19). The presence ofmicrovascular disease (retinopathy, microalbuminuria or neuropa-thy) is an independent risk factor for early death in COVID-19.Microvascular dysfunction is a systemic condition which includespulmonary manifestations. Impaired gas transfer, due to micro-angiopathy in type 2 diabetes, suggests that individuals will bevulnerable to the pro-inflammatory state and microthrombi char-acteristic of ‘endothelitis’ in COVID-19. Drugs that improve bloodflow in the intrapulmonary peri-alveolar microcirculation – namely,nitric oxide or phosphodiesterase-5 inhibitors – are thereforepromising candidates for clinical trials in COVID-19.