Does diabetes increase the risk of long COVID?

Does diabetes increase the risk of long COVID?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). A recent oneeClinicalMedicine Study examines whether people with diabetes are more susceptible to developing long-COVID, which is defined as a prolonged persistence of symptoms following a SARS-CoV-2 infection.

What causes long COVID?

Long COVID is described as persistence of symptoms or development of multisystem syndrome after recovery from the first SARS-CoV-2 infection. Common features of long COVID include muscle weakness, difficulty concentrating/brain fog, fatigue, and malaise. Other less common symptoms of long COVID include chest pain, headache, excessive sweating, anxiety and sore throat.

Although scientists have identified several factors that contribute to the development of long COVID, few studies have examined the prevalence of long COVID at the population level. It is important to understand whether this prevalence varies depending on a particular comorbidity.

About the study

The current retrospective observational cohort study examined the prevalence of long-COVID in the UK population. The researchers were particularly interested in studying people with diabetes because several studies confirmed that people with a history of diabetes mellitus are at higher risk of developing adverse consequences of acute SARS-CoV-2 infection.

All relevant electronic health record (EHR) data were obtained from the Greater Manchester Care Record (GMCR). This database contains the primary health care records of approximately 2.87 million people in Greater Manchester.

The current study examined whether people with type 1 diabetes (T1D) or T2D are susceptible to developing long COVID after SARS-CoV-2 infection. For this purpose, individuals with a history of T1D or T2D and COVID-19 confirmed by polymerase chain reaction (PCR) testing were considered.

Each participant with T1D or T2D was matched by age and gender to healthy or non-diabetic controls. It is important that all study participants tested positive for COVID-19 even 28 days after recovery from the initial infection.

Study results

A total of 3,087 T1D individuals were compared with 14,077 non-diabetic controls, while 3,087 individuals with T2D were compared with 14,077 non-diabetic controls. The average age of those diagnosed with T1D and T2D was 47 and 65 years, respectively. All patients with T1D were treated with insulin, while those with T2D were treated with insulin and oral hypoglycemic agents.

The researchers assumed that people with type 2 diabetes regularly visit general practices to monitor their condition. This increases the likelihood that long COVID infection will be diagnosed more efficiently.

People with type 1 diabetes were associated with a lower rate of long-term COVID diagnoses or referrals, at 0.33%, compared to 0.48% in matched controls. Compared to men with T2D, matched non-T2D controls were less likely to develop long COVID disease.

The prevalence of long COVID was higher in matched controls than in women with type 2 diabetes. Both men and women with T2D had similar prevalence of long COVID.

A bidirectional association between long COVID, T2D and acute COVID-19 was observed. People with a higher body mass index (BMI), younger women, or people of mixed ethnicity who were diagnosed with T2D were at higher risk of developing long COVID.

It is possible that younger women with type 2 diabetes were more susceptible to long COVID, as this group tended to visit general practices more often than men.

Strengths and limitations

The greatest strength of the current study is its cohort, which included all general practices in Greater Manchester. Additionally, only participants who were clearly diagnosed with diabetes were included in the analysis. Another strength of this study is its consideration of the wide-ranging period of the COVID-19 pandemic from its onset to September 2023.

Consistent with previous reports, the current study also recognizes that the diagnosis of long COVID varies. Although it is possible that people with acute SARS-CoV-2 infection are underreported, the number of diabetics and non-diabetics remained constant.

Another limitation is the exclusion of people with other forms of diabetes, such as: B. Diabetes due to adult-onset diabetes in young people (MODY) or as a result of pancreatitis.

Despite these limitations, the current study showed that people with type 2 diabetes are more likely to develop long COVID. Therefore, further research is needed to identify the different factors that increase the risk of long COVID.

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