What is the impact of microvascular complications of diabetes on severe COVID-19?

Microvasc Res. 2022 Mar:140:104310. doi: 10.1016/j.mvr.2021.104310. Epub 2021 Dec 31.

Abstract

Evidence suggests severe coronavirus disease-19 (COVID-19) infection is characterised by pulmonary and systemic microvasculature dysfunction, specifically, acute endothelial injury, hypercoagulation and increased capillary permeability. Diabetes, which is also characterised by vascular injury in itself, confers an increased risk of adverse COVID-19 outcomes. It has been suggested that pre-existing endothelial dysfunction and microvascular disease in diabetes will exacerbate the vascular insults associated with COVID-19 and thus lead to increased severity of COVID-19 infection. In this article, we evaluate the current evidence exploring the impact of microvascular complications, in the form of diabetic retinopathy and nephropathy, in individuals with COVID-19 and diabetes. Future insights gained from exploring the microvascular injury patterns and clinical outcomes may come to influence care delivery algorithms for either of these conditions.

Keywords: Albuminuria; COVID-19; Diabetes; Diabetic nephropathy; Endothelial dysfunction; Microvascular disease; Retinopathy.

Publication types

  • Review

MeSH terms

  • Albuminuria / etiology
  • COVID-19 / complications
  • COVID-19 / physiopathology*
  • Capillary Permeability
  • Delivery of Health Care
  • Diabetic Angiopathies / complications
  • Diabetic Angiopathies / physiopathology*
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / physiopathology
  • Diabetic Neuropathies / complications
  • Diabetic Neuropathies / physiopathology
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / physiopathology
  • Endothelium, Vascular / injuries
  • Endothelium, Vascular / pathology*
  • Humans
  • Microcirculation*
  • Obesity / complications
  • Obesity / physiopathology
  • Pandemics*
  • Pulmonary Circulation
  • Pulmonary Edema / etiology
  • Pulmonary Edema / physiopathology
  • SARS-CoV-2*
  • Severity of Illness Index
  • Thrombophilia / etiology*
  • Thrombophilia / physiopathology
  • Treatment Outcome