Severe COVID-19 risk with diabetic retinopathy

People with diabetic retinopathy are at a raised risk if they become infected with COVID-19, a study has found.

This condition develops due to damage to the small blood vessels in the eye in just over half of people with type 1 diabetes and 30% of people with type 2 diabetes.

Dr Antonella Corcillo and her team at King’s College London, UK, tested 187 people with diabetes (eight of whom had type 1 diabetes), all hospitalised with COVID-19. Overall, 36% had diabetic retinopathy.

This group had a five-fold higher risk of needing artificial ventilation. However, there was no link between retinopathy and mortality.

The study was published yesterday (24 November) in Diabetes Research and Clinical Practice.

Dr Corcillo says: "This is the first time that retinopathy has been linked to 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 may result in a more severe COVID-19 infection requiring intensive care treatment.”

The paper’s senior author, Dr Janaka Karalliedde, added: "There is increasing evidence that there is significant damage to the blood vessels in the lung and other organs in patients hospitalised with severe COVID-19.

“People with diabetes are at high risk of vascular complications affecting the large and small blood vessels.

"We hypothesise that the presence of diabetes related vascular disease such as retinopathy may result in greater vulnerability and susceptibility to respiratory failure. Therefore, looking for presence or history of retinopathy or other vascular complications of diabetes may help health care professionals identify patients at high risk.”

Corcillo, A. et al. Diabetic retinopathy is independently associated with increased risk of intubation: a single centre cohort study of patients with diabetes hospitalised with COVID-19. Diabetes Research and Clinical Practice 24 November 2020

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