medwireNews: The risk for receiving a new diabetes diagnosis is increased “for at least 12 weeks” after COVID-19 illness, but then declines, say researchers.
Martin Gulliford (King’s College London, UK) and team also found an increased risk for cardiovascular disease (CVD), mainly accounted for by a sharp increase in the rate of pulmonary embolism.
“However, people without preexisting CVD or [diabetes] who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions,” the team writes in PLOS Medicine.
The study involved 428,650 people with a COVID-19 diagnosis, identified in the UK’s Clinical Practice Research Datalink, who were matched by year of birth, sex, and family physician practice to an equal number of people without a diagnosis.
People with COVID-19 were more likely to be of Asian ethnicity, overweight or obese, and to have more comorbidity than their matched counterparts, but they were less likely to smoke.
They also had a slightly elevated incidence of diabetes even in the year before their COVID-19 diagnosis, at 15.81 new cases per 100,000 patient–weeks compared with 11.32 per 100,000 patient–weeks in people who did not get COVID-19. And the same was true for CVD events, at a corresponding 14.07 versus 7.58 per 100,000 patient–weeks.
But rates of both outcomes increased sharply during the first 4 weeks after COVID-19 diagnosis. Diagnosis rates per 100,000 patient–weeks were 23.79 versus 9.48 for diabetes in people with versus without COVID-19, and 76.92 versus 7.31 for CVD.
Rates of both outcomes per 100,000 patient–weeks remained elevated in the post-acute period (weeks 5–12), at 19.54 versus 11.10 for diabetes in people with versus without COVID-19 and 22.06 versus 8.41 for CVD.
Between 13 and 52 weeks after infection, the rate of diabetes diagnosis remained elevated, at 19.57 versus 13.17 per 100,000 patient–weeks in those with versus without COVID-19, whereas the CVD rate returned to baseline level, at a corresponding 12.63 versus 9.09.
Secondary analysis by 4-week periods indicated that diabetes diagnosis rates remained increased until weeks 20–23 but had returned to normal by weeks 24–27.
“Cardiovascular conditions are often associated with acute presentations that may lead to early diagnosis; this is in contrast to diabetes which may remain undiagnosed for a variable period of time, possibly contributing to the more delayed decline in the latter condition with consultation rates changing over time,” say Gulliford and team.
They conclude: “Advice to patients recovering from COVID-19 should include measures to reduce diabetes risk, including diet, weight management, and physical activity levels, especially in view of heightened baseline risk.”
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