Macular degeneration patients may be at greater risk of COVID complications

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The American Macular Degeneration Foundation (AMDF) is updating its COVID-19 guidelines based on findings from a peer-reviewed study recently published in Nature Medicine. According to the study, patients with age-related macular degeneration (AMD) who become infected with SARS-CoV-2, the virus that causes COVID-19, are at higher risk of developing severe complications including requiring supplemental oxygen and death. AMDF is distributing this information to alert AMD patients and eye care practitioners of the potential risk. 

“At AMDF, we believe it’s important that this information, even if it is preliminary, be in the hands of patients so they can make considered decisions about their safety as they go about their lives,” says Chip Goehring, President, AMDF. “We want to raise awareness, not anxiety.  AMD patients who require anti-VEGF injections for the wet form of the disease — or who experience sudden changes in vision and have dry AMD — should continue their treatment. Retina clinics and ophthalmologists’ offices maintain extremely safe environments.”

The investigation of 6,398 COVID-19 patients hospitalized at New York – Presbyterian/Columbia University Irving Medical Center during the first wave of the pandemic found that the AMD patients succumbed to the disease more rapidly than others, died at three times the rate of COVID-19 patients who did not have AMD, and required intubation in one out of five cases.

“This does not mean that AMD patients are more likely to become infected with coronavirus,” says Sagi Shapira, PhD, MPH, who led the study with Nicholas Tatonetti, PhD, both professors at Columbia University Vagelos College of Physicians and Surgeons. “Everyone’s risk of getting infected is entirely dependent on their behavior. But these findings left no doubt that, once infected, those with macular degeneration are at greater risk of developing catastrophic disease symptoms.”

The study, entitled “Immune complement and coagulation dysfunction in adverse outcomes of SARS-CoV-2 infection,” was designed to understand the relationship between COVID-19 and the complement system, a core facet of the body’s immune response to infection. The researchers used AMD as a proxy for complement dysfunction because those with AMD are known to have hyperactive complement activity. That coronaviruses engage and activate the body’s immune complement system had been previously demonstrated and was further demonstrated as part of the published study. Overall, the study showed that complement dysfunction is associated with severe disease, affecting a population of patients that includes those with AMD. Importantly, the greater mortality and intubation rates could not be explained by differences in the age or sex of the patients.

“This suggests,” adds Dr. Shapira, “that those with AMD should err on the side of caution and implement recommended practices for avoiding infection, such as wearing a mask, social distancing, hand sanitation, avoiding gatherings with people whose COVID status they don’t know, and other CDC-recommended guidelines.”

The American Macular Degeneration Foundation also offers the guide:“Coronavirus and Your Macular Degeneration Care.”

The American Macular Degeneration Foundation (macular.org) is a patient-centric foundation that supports potentially game-changing AMD research, education and advocacy in order to improve quality of life and treatment outcomes for all of those affected by AMD.

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