Understanding Post-COVID Risks: Diabetes and Kidney Health in Patients
More Programs and Publications Featuring Dr. Rodney Rohde
In this program:
Post-COVID-19 patients have a higher risk of some complications, but what about diabetes and kidney health? Medical laboratory scientist Dr. Rodney Rohde discusses the impact of COVID-19 on type 2 diabetes risk and chronic kidney disease risk as well as advice for being proactive about your future health.
Transcript
Interviewer:
COVID has a disproportionate effect on vulnerable communities. So when combined with non-infectious diseases that already can disproportionately affect these very same communities such as type 2 diabetes or chronic kidney disease, how does this increase risk, or how does this increase the risk of worsened symptoms of the COVID virus?
Dr. Rodney Rohde:
What we're seeing in the research right now is that there's about a 60 percent increase right now in risk for new onset diabetes in people who had COVID-19. And usually, this is type 2, which you mentioned, compared with people who have never had COVID-19. And the particular study I looked at, looked at about 180,000 veterans that showed those who had COVID-19 had about a 40 percent.
So you have 4 out of 10 chance, a higher risk of new diabetes as compared with all the control populations after about a year. So that's a pretty significant risk factor. The combined risk of type 2 diabetes after just a COVID-19 exposure, and this is looking at both vaccinated and unvaccinated patients, was about 2.1 percent. And that study shows about 70 percent occurred after COVID-19 infection versus 30 percent happening prior to an actual exposure. So again, 40 percent more problems of developing type 2 diabetes in that situation. The other type of vulnerable community that you mentioned, the chronic kidney disease, a community can develop, typically what we're seeing is that typically they're developing the same complications as COVID-19 is those without chronic kidney disease (CKD), for example, COVID pneumonia, acute respiratory distress, and even some types of blood clotting abnormalities. There are some other risk factors to consider around kidney function in people with CKD who actually get COVID-19.
So we believe it's pretty clear that COVID-19 can affect the kidneys. Most of the research has shown that if you...from way early, we saw some of those types of things where we were actually isolating not only virus, but viral rNA in all sorts of tissues and fluids in the body. So that was way back early. So that was really concerning, because we were seeing it all over the place, not just in the respiratory system. But it's still, Deandre, this is still kind of an area of research. There's not a lot of clear understanding right now on the long-term effects of whether people with CKD are going to have super long long COVID problems. I did find the global burden of disease collaboration project identified globally that CKD is, and tends to be one of the more prevalent risk factors for severe COVID, and that when you start looking at mortality, it seems to be different in patients with CKD than compared to the general population.
So they're still kind of teasing that out. One specific lab indicator that I saw that was kind of interesting is that, when patients have a kidney dysfunction, for example, an eGFR, less than 60 mils per minute, when they're hospitalized, they tend to have a much higher multi-organ failure. So things like sepsis, respiratory failure and acute kidney injury, AKI can cause almost a tripling effect of that. So that's pretty concerning. And then the last thing I would mention around COVID, and this type of problem is that, right now, the Centers for Disease Control, World Health Organization, many of those reputable sites and places that kind of coalesce all this information recommend that you continue to use your regular medications if you have CKD. Again, in consultation with your healthcare provider, really for both conditions, if you have a COVID infection. So whether it's type two diabetes or CKD, you really want to continue your medications, but consult with your physician if you're having any type of complications for maybe a different pathway.
Interviewer:
For the research you had identified regarding the veterans having increased risk of getting diabetes type 2 with COVID, was there any research regarding them being pre-diabetic, or was there a subset of that population of veterans that were pre-diabetic that kind of just increased that risk factor on top of the COVID, or was it really just another factor?
Dr. Rodney Rohde:
They didn't really report that with pre-diabetes, which is definitely a great question. I'm sure those research studies are probably happening because as you know, many, many people including we Americans are pre-diabetic. In fact, I'm not pre-diabetic, but I have it in my history. My parents are both right on the edge of that. So I'm expecting to deal with that when I get into my 60s. So again just like me, whether you're a healthcare professional that might know these things or family or friends, you really should always be looking at your medical laboratory testing. You should be having annual checkups, and visiting with your primary care physician to kind of understand those risks, whether it's pre-diabetes or other issues around cancer and things like that. You really want to be aware of that as a risk factor as we're talking about.
Interviewer:
Yes, it's so hard to understand the association of COVID with disease you don't really think about this with diabetes or chronic kidney disease. It's easy to think of COPD as having associated with COVID. It's just an immediate association, but other diseases, where the information and the research does show that there's association, you wouldn't really know that as a patient, honestly.
Dr. Rodney Rohde:
Right. And I think what we're talking about here is so important, and I love this about these opportunities to share with the public, is that these conversations with your physician, your healthcare team are so important, because as you just stated, even understanding what's causation, correlation or association, these are all statistical terms that professionals use in healthcare and research. My parents don't understand that, and so I have to sit down with them and talk about not to really scare people, but to kind of educate them, right? So that they know you are okay, but here's something you should keep an eye on, and have your physician understand that it's in your genetics. Slide 3 And I think for our generation, it's becoming even better because now, we have those laboratory tests, we have those ways to kind of educate ourselves and work with our physician to be looking ahead, right? So you can look into your 40s and 50s and 60s. Even when you're in your 20s and 30s or a teenager, to start thinking about, do I have risk factors that I should care about when I get to be 45 years old or 60 years old?
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