ABSTRACT
End stage renal disease (ESRD) is associated with a high mortality rate among patients hospitalized with COVID-19. To the best of our knowledge, there is limited data on the clinical features, ethnicity, inpatient glycaemic control and outcomes in patients with diabetes related ESRD in the literature. We report the clinical features and outcomes of 39 consecutive ESRD patients (28 on haemodialysis [HD] and 11 with renal transplant) secondary to diabetic kidney disease admitted to a university hospital with COVID-19. We observed a high prevalence of patients of Afro-Caribbean ethnicity hospitalized with COVID-19 with a 73% and 54% prevalence in renal transplant and HD groups respectively. The mortality rate of our cohort was 36%. Nearly a one-third of HD patients and one-fifth of transplant patients had hypoglycaemic events during COVID-19 hospitalization. Adjustment of diabetes treatment was frequently required. Our data highlight the importance of integrated multidisciplinary care of patients with diabetes related ESRD hospitalized with COVID-19.
Subject(s)
Blood Glucose/analysis , COVID-19 , Diabetes Complications , Ethnicity/statistics & numerical data , Hypoglycemia , Kidney Failure, Chronic , Renal Dialysis/statistics & numerical data , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/therapy , Caribbean Region , Diabetes Complications/blood , Diabetes Complications/ethnology , Diabetes Complications/physiopathology , Female , Humans , Hypoglycemia/diagnosis , Hypoglycemia/etiology , Kidney Failure, Chronic/ethnology , Kidney Failure, Chronic/etiology , Kidney Failure, Chronic/therapy , Kidney Transplantation/statistics & numerical data , Male , Middle Aged , Needs Assessment , Patient Care Team , Risk Factors , SARS-CoV-2/isolation & purification , United Kingdom/epidemiologyABSTRACT
In our study of 187 patients with diabetes hospitalised with COVID-19 we observed a more than 5 fold increased risk of intubation in patients with diabetic retinopathy. Further studies are required to understand the mechanisms that explain the associations between retinopathy and other indices of microangiopathy with severe COVID-19.