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Findings from a new study suggest that people with diabetes and eye disease have a five times greater risk of requiring intubation when admitted to hospital with COVID-19. The study, published today in King’s College London’s Diabetes Research and Clinical Practice, identified the risk associated with diabetic retinopathy and COVID-19 for the first time.
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 looked at 187 people with diabetes (179 with type 2 diabetes and 8 with type 1 diabetes) admitted to hospital with COVID-19 at Guy’s and St Thomas’ NHS Foundation Trust between March 12 and April 7, 2020.
Diabetic retinopathy was reported in 67 (36%) of patients, the majority with underlying retinopathy. Of the 187 patients admitted 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 King’s College London’s School of Cardiovascular Medicine and Sciences, said, “This is the first time that retinopathy has been linked to severe COVID-19 in people with diabetes. Retinopathy is a marker of blood vessel damage, and our findings suggest that such pre-existing blood vessel damage may result in a more severe COVID-19 infection that requires intensive care treatment.
Senior author Dr Janaka Karalliedde of King’s College London said, “There is growing evidence that there is significant damage to blood vessels in the lungs and other organs in hospitalized patients with severe COVID-19. with diabetes, vascular complications affecting large and small blood vessels are at high risk. “We hypothesize that the presence of diabetes-related vascular diseases 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 of diabetes can help healthcare professionals identify patients at high risk for severe COVID-19. Further studies are needed to investigate the possible mechanisms that explain the links between markers and manifestations of diabetic vascular diseases such as retinopathy and severe COVID-19. “
Dr Louise Gow, RNIB’s chief eye health specialist, said, “The RNIB hopes this research will result in greater awareness of those most at risk for serious complications from COVID-19. vaccine planning underway, it is necessary to consider the priority of people with diabetic retinopathy. It also stresses that it is imperative that information on COVID-19 be available in formats accessible to people with vision loss so they know how to protect themselves. Limitations of this study include its relatively small sample size and that, as it is a cross-sectional study, it is unable to identify a causal relationship between retinopathy and severe COVID-19 outcomes. (ANI)
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