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10-05-2021 | COVID-19 | Adis Journal Club | Article

Diabetes Therapy

Impact of SARS-CoV-2 on Progression of Glycemic and Cardiometabolic Variables and Changes in Insulin Indices: A Longitudinal Study

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Authors: Alpesh Goyal, Yashdeep Gupta, Mani Kalaivani, Neerja Bhatla & Nikhil Tandon

Abstract 

Introduction

We aimed to evaluate whether SARS-CoV-2 infection is associated with beta cell dysfunction and progression of glycemic and cardiometabolic variables in an established cohort.

Methods

Study participants (n = 352, 46.9% men) underwent a detailed evaluation at two time points: (a) pre-COVID (2016–19) and (b) peri-COVID (2020–21). At the second visit, SARS-CoV-2 infection was determined on the basis of a quantitative S1/S2 IgG antibody test (DiaSorin Liaison) and/or a documented history of infection.

Results

A total of 159 (45.2%) participants were seropositive for SARS-CoV-2, of whom 122 (76.7%) had mild/asymptomatic infection. Progression in body mass index (BMI) category [34 (21.4%) vs. 22 (11.4%), p = 0.011] was seen in a significantly higher proportion of the participants in the infected group compared to the non-infected group. Progression in glycemic and insulin indices [homeostasis model assessment of insulin resistance (HOMA-IR), Matsuda index, and oral disposition index (oDI)] categories was also evident in a larger proportion of participants in the infected group; however, the difference was not statistically significant. On logistic regression analysis, the association between SARS-CoV-2 infection and BMI category progression was statistically significant [fully adjusted OR 2.14 (95% CI, 1.18–3.90; p = 0.013)].

Conclusion

In this longitudinal study, predominant mild/asymptomatic SARS-CoV-2 infection was associated with increase in BMI, but not with worsening of beta cell function and insulin resistance, nor glycemic progression.

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Key Summary Points

Why carry out this study?

Diabetes and COVID-19 carry a bidirectional relationship. There is a paucity of data on the exact magnitude and pathophysiological link for beta cell dysfunction and new-onset diabetes following COVID-19, especially mild/asymptomatic disease.

This study aimed to evaluate whether SARS-CoV-2 infection is associated with beta cell dysfunction and progression of glycemic and cardiometabolic variables in an established cohort.

What was learned from the study

A significantly higher proportion of participants in the infected group progressed in body mass index (BMI) category, i.e., from normal weight to overweight or from overweight to obesity category.

Progression in glycemic and insulin indices [homeostasis model assessment of insulin resistance (HOMA-IR), Matsuda index, and oral disposition index (oDI)] categories was also evident in a larger proportion of participants in the infected group; however, the difference was not statistically significant.

To the best of our knowledge, this is the first study to formally evaluate the emerging concept of new-onset metabolic dysfunction following SARS-CoV-2 infection using a longitudinal cohort design.