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▎WuXi AppTec's content team editors increasingly suggest that after the acute phase of Covid-19 infection, infected individuals may also experience long-term symptoms beyond the respiratory system, including diabetes
.
Recently, two independent large-scale research data were published in the two authoritative medical journals in the field of diabetes, "The Lancet-Diabetes and Endocrinology", and Diabetologia under the European Association for the Study of Diabetes (EASD)
.
Two studies further support the phenomenon that people with new coronary infection face a higher risk of diabetes, and those with mild symptoms cannot be ignored
.
These findings suggest that care strategies following acute infection should include active screening and management of diabetes
.
Screenshot source: The Lancet Diabetes & Endocrinology study published in The Lancet-Diabetes and Endocrinology from the VA Saint Louis Health Care System
.
The cohort study included more than 180,000 survivors who tested positive for COVID-19 and survived the first 30 days of acute infection between March 2020 and September 2021
.
At the same time, two groups of patients who were not infected with the new crown were also recruited as controls: (1) nearly 4.
12 million people were recruited during the same period from March 2020 to September 2021 as the current control, (2) from the same healthcare database.
4.
287 million people with medical records from March 2018 to September 2019 were included as historical controls
.
All three groups of patients were free of diabetes at the time of inclusion in the study cohort, with a median follow-up of 352 days
.
After statistics, it was found that compared with the current control group, the risk of diabetes in the later stage of patients with new crown infection was significantly increased by 40%, and the risk of needing hypoglycemic drugs was significantly increased by 85%, which is equivalent to the occurrence of diabetes and diabetes 12 months after infection.
The burden of using hypoglycemic drugs increased by 13.
46 cases/1000 people and 12.
35 cases/1000 people respectively
.
The combined risk of developing diabetes or requiring the use of hypoglycemic agents in patients with new crown infection increased by 46% (18.
03 cases/1000 people after 12 months)
.
As the severity of the acute phase of COVID-19 infection increases (no hospitalization, hospitalization, or intensive care), the risk of new-onset diabetes or the need for re-use of antidiabetic drugs also increases
.
It is worth noting that even for mild, non-hospitalized patients with new coronary infection, the additional burden of new-onset diabetes or taking hypoglycemic drugs increased by 8.
28/1000 people after 1 year
.
▲Compared with the current control group, as the severity of the disease in the acute phase of new coronary infection increased, the risk of new-onset diabetes, the risk of needing hypoglycemic drugs, and the risk of the composite outcome of the two also increased significantly
.
(Image source: Reference [1]) Different age (≤65 years and >65 years old), ethnicity (white and black), gender (male and female), and BM category (>18.
5~≤25, >25~ ≤30, >30) and socioeconomic status, consistent trends were observed
.
But relatively speaking, 65-year-old people, black patients, people with cardiovascular disease, hypertension, hyperlipidemia or prediabetes, people with BMI>25, after infection with the new crown, new-onset diabetes or need to use hypoglycemic medicines are more risky
.
In comparison with the historical control group, the conclusions are also consistent
.
Continuing these data, the paper states that survivors may be at increased risk for new-onset diabetes or the use of hypoglycemic agents after the acute phase of Covid-19 infection, and that diabetes should be considered an aspect of the prolonged Covid-19 syndrome
.
Screenshot source: The Lancet Diabetes & Endocrinology A retrospective cohort study published in Diabetologia from Heinrich Heine University Düsseldorf, Germany
.
The study data was provided by a group of 1,171 physician representatives across Germany covering 8.
8 million patients
.
Between March 2020 and January 2021, a total of 35,865 positive cases of new crowns were recorded, and other patients with acute upper respiratory tract infections (usually caused by viruses) were listed as the control group.
The two groups were based on gender, age, health insurance status, infection Matching by month and comorbidity (obesity, hypertension, hyperlipidemia, myocardial infarction, stroke) resulted in similar demographic (mean age 43; 46% female) and clinical characteristics between the two groups
.
By July 2021, the median follow-up time of the new crown group was 119 days; the median follow-up time of the control group was 161 days
.
Analysis of the risk of newly diagnosed diabetes (diagnostic criteria is ICD-10) found that compared with other acute upper respiratory tract infections, the risk of type 2 diabetes in patients with new crown was significantly higher by 28% (15.
8 cases/1000 people-year vs 12.
3/1000 people).
- year), no increased risk of other forms of diabetes
.
"COVID-19 infection may lead to diabetes by upregulating the immune system, which may lead to pancreatic beta-cell dysfunction and insulin resistance, or patients may be at risk for developing diabetes due to obesity or prediabetes, and the stress of COVID-19 accelerates the disease happens
,
" noted study corresponding author Dr.
Wolfgang Rathmann
.
However, because the study follow-up period was only about 4 months, "further follow-up is needed to understand whether mild post-COVID-19 type 2 diabetes is only temporary, can be reversed after full recovery, or eventually leads to chronic disease
.
"Image source: 123RF The Lancet-Diabetes and Endocrinology concurrent review article noted that these findings warrant prospective studies in the wider population to confirm long-term health effects
.
The article suggests that more standardized assessments of diabetes diagnostics are needed in the future .
, More detailed analysis of potential factors affecting sequelae (such as infection severity, viral load, and the presence of antibodies to autoimmune attack); in addition, the underlying mechanism of the association between new crown infection and diabetes needs to be explored
.
Given that increasing the burden of diabetes will bring With far-reaching implications, identifying the association between COVID-19 infection and diabetes risk is important for clinical strategy and public health
.
Related reading Cao Bin/Wang Jianwei's team is heavy: New crown recovered patients still have immune memory after 1 year, and the factor of resistance to variants is critical "The Lancet" Depth: Nucleic acid/antigen/antibody, the three types of new crown detection methods, what are the effects of epidemic prevention and control? NEJM real-world study: What will be the consequences of the Omikron epidemic under the herd immunity barrier? References (swipe up and down to view) [1] Yan Xie, Ziyad Al-Aly, et al.
, (2022).
Risks and burdens of incident diabetes in long COVID: a cohort study.
In The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(22)00044-4[2] KM Venkat Narayan, Lisa R Staimez.
(2022).
Rising diabetes diagnosis in long COVID.
In The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(22)00078-X[3] Rathmann, W.
, Kuss, O.
& Kostev, K.
(2022).
Incidence of newly diagnosed diabetes after Covid-19.
Diabetologia, DOI: https://doi.
org/10.
1007/s00125-022-05670-0[4] Mild COVID-19 Infection Linked to Later Type 2 Diabetes.
Retrieved March 28, 2022 from https://
This article is for information exchange purposes only, and the views expressed in this article do not represent WuXi AppTec's position, nor do they represent WuXi AppTec's support or opposition to the views expressed in this article
.
This article is also not a treatment plan recommendation
.
For guidance on treatment options, please visit a regular hospital
.
.
Recently, two independent large-scale research data were published in the two authoritative medical journals in the field of diabetes, "The Lancet-Diabetes and Endocrinology", and Diabetologia under the European Association for the Study of Diabetes (EASD)
.
Two studies further support the phenomenon that people with new coronary infection face a higher risk of diabetes, and those with mild symptoms cannot be ignored
.
These findings suggest that care strategies following acute infection should include active screening and management of diabetes
.
Screenshot source: The Lancet Diabetes & Endocrinology study published in The Lancet-Diabetes and Endocrinology from the VA Saint Louis Health Care System
.
The cohort study included more than 180,000 survivors who tested positive for COVID-19 and survived the first 30 days of acute infection between March 2020 and September 2021
.
At the same time, two groups of patients who were not infected with the new crown were also recruited as controls: (1) nearly 4.
12 million people were recruited during the same period from March 2020 to September 2021 as the current control, (2) from the same healthcare database.
4.
287 million people with medical records from March 2018 to September 2019 were included as historical controls
.
All three groups of patients were free of diabetes at the time of inclusion in the study cohort, with a median follow-up of 352 days
.
After statistics, it was found that compared with the current control group, the risk of diabetes in the later stage of patients with new crown infection was significantly increased by 40%, and the risk of needing hypoglycemic drugs was significantly increased by 85%, which is equivalent to the occurrence of diabetes and diabetes 12 months after infection.
The burden of using hypoglycemic drugs increased by 13.
46 cases/1000 people and 12.
35 cases/1000 people respectively
.
The combined risk of developing diabetes or requiring the use of hypoglycemic agents in patients with new crown infection increased by 46% (18.
03 cases/1000 people after 12 months)
.
As the severity of the acute phase of COVID-19 infection increases (no hospitalization, hospitalization, or intensive care), the risk of new-onset diabetes or the need for re-use of antidiabetic drugs also increases
.
It is worth noting that even for mild, non-hospitalized patients with new coronary infection, the additional burden of new-onset diabetes or taking hypoglycemic drugs increased by 8.
28/1000 people after 1 year
.
▲Compared with the current control group, as the severity of the disease in the acute phase of new coronary infection increased, the risk of new-onset diabetes, the risk of needing hypoglycemic drugs, and the risk of the composite outcome of the two also increased significantly
.
(Image source: Reference [1]) Different age (≤65 years and >65 years old), ethnicity (white and black), gender (male and female), and BM category (>18.
5~≤25, >25~ ≤30, >30) and socioeconomic status, consistent trends were observed
.
But relatively speaking, 65-year-old people, black patients, people with cardiovascular disease, hypertension, hyperlipidemia or prediabetes, people with BMI>25, after infection with the new crown, new-onset diabetes or need to use hypoglycemic medicines are more risky
.
In comparison with the historical control group, the conclusions are also consistent
.
Continuing these data, the paper states that survivors may be at increased risk for new-onset diabetes or the use of hypoglycemic agents after the acute phase of Covid-19 infection, and that diabetes should be considered an aspect of the prolonged Covid-19 syndrome
.
Screenshot source: The Lancet Diabetes & Endocrinology A retrospective cohort study published in Diabetologia from Heinrich Heine University Düsseldorf, Germany
.
The study data was provided by a group of 1,171 physician representatives across Germany covering 8.
8 million patients
.
Between March 2020 and January 2021, a total of 35,865 positive cases of new crowns were recorded, and other patients with acute upper respiratory tract infections (usually caused by viruses) were listed as the control group.
The two groups were based on gender, age, health insurance status, infection Matching by month and comorbidity (obesity, hypertension, hyperlipidemia, myocardial infarction, stroke) resulted in similar demographic (mean age 43; 46% female) and clinical characteristics between the two groups
.
By July 2021, the median follow-up time of the new crown group was 119 days; the median follow-up time of the control group was 161 days
.
Analysis of the risk of newly diagnosed diabetes (diagnostic criteria is ICD-10) found that compared with other acute upper respiratory tract infections, the risk of type 2 diabetes in patients with new crown was significantly higher by 28% (15.
8 cases/1000 people-year vs 12.
3/1000 people).
- year), no increased risk of other forms of diabetes
.
"COVID-19 infection may lead to diabetes by upregulating the immune system, which may lead to pancreatic beta-cell dysfunction and insulin resistance, or patients may be at risk for developing diabetes due to obesity or prediabetes, and the stress of COVID-19 accelerates the disease happens
,
" noted study corresponding author Dr.
Wolfgang Rathmann
.
However, because the study follow-up period was only about 4 months, "further follow-up is needed to understand whether mild post-COVID-19 type 2 diabetes is only temporary, can be reversed after full recovery, or eventually leads to chronic disease
.
"Image source: 123RF The Lancet-Diabetes and Endocrinology concurrent review article noted that these findings warrant prospective studies in the wider population to confirm long-term health effects
.
The article suggests that more standardized assessments of diabetes diagnostics are needed in the future .
, More detailed analysis of potential factors affecting sequelae (such as infection severity, viral load, and the presence of antibodies to autoimmune attack); in addition, the underlying mechanism of the association between new crown infection and diabetes needs to be explored
.
Given that increasing the burden of diabetes will bring With far-reaching implications, identifying the association between COVID-19 infection and diabetes risk is important for clinical strategy and public health
.
Related reading Cao Bin/Wang Jianwei's team is heavy: New crown recovered patients still have immune memory after 1 year, and the factor of resistance to variants is critical "The Lancet" Depth: Nucleic acid/antigen/antibody, the three types of new crown detection methods, what are the effects of epidemic prevention and control? NEJM real-world study: What will be the consequences of the Omikron epidemic under the herd immunity barrier? References (swipe up and down to view) [1] Yan Xie, Ziyad Al-Aly, et al.
, (2022).
Risks and burdens of incident diabetes in long COVID: a cohort study.
In The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(22)00044-4[2] KM Venkat Narayan, Lisa R Staimez.
(2022).
Rising diabetes diagnosis in long COVID.
In The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(22)00078-X[3] Rathmann, W.
, Kuss, O.
& Kostev, K.
(2022).
Incidence of newly diagnosed diabetes after Covid-19.
Diabetologia, DOI: https://doi.
org/10.
1007/s00125-022-05670-0[4] Mild COVID-19 Infection Linked to Later Type 2 Diabetes.
Retrieved March 28, 2022 from https://
This article is for information exchange purposes only, and the views expressed in this article do not represent WuXi AppTec's position, nor do they represent WuXi AppTec's support or opposition to the views expressed in this article
.
This article is also not a treatment plan recommendation
.
For guidance on treatment options, please visit a regular hospital
.
