People with diabetes and eye disease have a five-fold increased risk of intubation when they are hospitalized with Covid-19, a new study finds.
The study, published today in Diabetes Research and Clinical Practice by King’s College London, for the first time identified the risk associated with diabetic retinopathy and Covid-19.
Diabetic eye disease is a common complication of diabetes and is caused by damage to the small blood vessels in the eye. In 2014, the prevalence of diabetic retinopathy was 54.6% in people with type 1 diabetes and 30.0% in people with type 2 diabetes.
The study examined 187 people with diabetes (179 with type 2 diabetes and 8 with type 1 diabetes) who were hospitalized with Covid-19 between March 12 and April 7, 2020 at Guy’s and St Thomas’ NHS Foundation Trust.
Diabetic retinopathy was reported in 67 (36%) of patients, the majority with background retinopathy. Of 187 patients hospitalized with severe Covid-19, 26% were intubated and 45% of these patients had retinopathy. Retinopathy was associated with a five-fold increased risk of intubation. In the cohort, 32% of patients died and no association between retinopathy and mortality was observed.
First author of the study, Dr. Antonella Corcillo of the School of Cardiovascular Medicine and Sciences at King’s College London said, “This is the first time that retinopathy has been associated with severe Covid-19 in people with diabetes. Retinopathy is a marker of damage to the blood vessels and our results suggest that such pre-existing damage to blood vessels can lead to a more serious Covid-19 infection requiring intensive care.
Senior author, Dr. Janaka Karalliedde of King’s College London, said: “There is growing evidence of significant damage to the blood vessels in the lungs and other organs in patients hospitalized with severe Covid-19. People with diabetes are at high risk for vascular complications that affect the large and small blood vessels.
“Our hypothesis is that the presence of diabetes-related vascular conditions such as retinopathy may lead to greater vulnerability and susceptibility to respiratory failure in severe Covid-19. Therefore, looking for the presence or history of retinopathy or other vascular complications from diabetes can help health care providers identify patients at high risk for severe Covid-19. Further studies are needed to investigate the possible mechanisms explaining the links between markers and manifestations of diabetic vascular conditions such as retinopathy and severe Covid-19. “
Dr. Louise Gow, the RNIB’s specialist head for eye health, said: “RNIB hopes this research will result in greater awareness of those most at risk of serious complications from Covid-19. Now that vaccination planning is underway, consideration should be given to prioritizing people with diabetic retinopathy. It also emphasizes that it is vital that information about Covid-19 be available in formats accessible to people with vision loss so that they know how to protect themselves. “
Limitations of this study include the relatively small sample size and the fact that since it is a cross-sectional study, it cannot identify a causal relationship between retinopathy and severe Covid-19 outcomes.
(This story was published from a message from a telegraph agency with no changes to the text. Only the headline has been changed.)
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