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This review examines the interplay between COVID-19, cholesterol metabolism, and diabetes, focusing on the differences in lipid regulation between Type I (T1DM) and Type II diabetes (T2DM). Diabetes, characterized by impaired glucose regulation and lipid homeostasis, has been identified as a significant risk factor for severe COVID-19 outcomes, including increased rates of hospitalization, ICU admission, and mortality. Dysregulated cholesterol metabolism is often present in diabetic patients and exacerbates the severity of COVID-19. We explore the mechanisms by which SARS-CoV-2 infection affects cholesterol pathways, highlighting the role of cholesterol-rich lipid rafts in viral entry and replication. The review also discusses the potential therapeutic implications of targeting cholesterol metabolism in managing COVID-19 in diabetic populations. Understanding these complex interactions may provide insights into better clinical management strategies and improve outcomes for COVID-19 patients with diabetes.<\/jats:p>","DOI":"10.1007\/s42977-025-00285-z","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T16:22:04Z","timestamp":1754929324000},"page":"497-505","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 and dysregulated cholesterol levels in Type I and Type II diabetes: focus on the difference"],"prefix":"10.1007","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8285-2762","authenticated-orcid":false,"given":"Ganna","family":"Stepanova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6618-930X","authenticated-orcid":false,"given":"Sayam","family":"Ghosal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"issue":"3","key":"285_CR1","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1007\/s11154-021-09705-6","volume":"23","author":"JH Bae","year":"2022","unstructured":"Bae JH, Choe HJ, Holick MF, Lim S (2022) Association of vitamin D status with COVID-19 and its severity: vitamin D and COVID-19: a narrative review. 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