Diabetes & Covid-19; Southampton Critical Care; Antigen Tests; Cytokine Storm

Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 infection.Erika Wright is back at University Hospital Southampton NHS Foundation Trust. Clinical lead and consultant in critical care, Dr Sanjay Gupta, talks about success giving critically ill patients oxygen using non-invasive ventilation: CPAP - continuous positive airway pressure. He also describes reorganising the hospital's critical care into four sections: patients positive for Covid, negative for Covid, those waiting for test results and those who test negative but are symptoms positive. Nationally, he tells Erika, those who falsely test negative, is between 5-10%.And Inside Health contributor Dr Margaret McCartney delves into the accuracy of antigen swab tests (the test that tells you whether you have the virus or not). False negatives, test results that report the person doesn't have the virus when in fact they do, have serious implications for health care professionals, who might return to work on the basis of a mistaken result. Caution is advised, Dr McCartney advises, when symptoms contradict the test result. A cytokine storm is a variant on a hyperactive immune reaction, where the body thinks its own tissues are invaders. Cytokines are small proteins that trigger more immune activity or less. In a cytokine storm the cytokines rage through the bloodstream, throwing our immune system out of balance and leading to severe illness and even death. This hyper inflammation has been seen in Covid-19 patients and Dr Jessica Manson, consultant rheumatologist at University College London Hospitals and co-chair of the national group of hyper inflammation doctors, tells Claudia what is and isn't known about how to treat cytokine storms in patients with coronavirus.Producer: Fiona Hill