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Risk of Diabetes, Cardiovascular Disease Higher After COVID-19

There is a potential increased risk of developing diabetes mellitus (DM) and cardiovascular disease (CVD) after contracting COVID-19, according to new research.

The United Kingdom study, published in PLOS Medicine,1 found an 81% increased risk in DM in the first 4 weeks after COVID-19, with rates remaining high for 12 weeks.

The researchers assessed cardiometabolic outcomes up to 12 months after COVID-19 infection among patients in the United Kingdom, utilizingElectronic Health Record data from more than 1300 family practices in the United Kingdom involving data from more than 850,000 patients, according to a statement2 from Kings College London.

Acute COVID-19 was also associated with net increased CVD incidence (aRR, 5.82), including incidence of pulmonary embolism (aRR, 11.51 [95% CI, 7.07-18.73]), atrial arrhythmias (6.44, 4.17 to 9.96), and venous thrombosis (aRR, 5.43 [95% CI, 3.27-9.01]). CVD incidence declined from weeks 5-12 (aRR, 1.49 [95% CI, 1.28-1.73]) and showed a net decrease from 13-52 weeks (aRR, 0.80 [95% CI, 0.73-0.88]).

It is not surprising that COVID-19 infections could increase the risk of DM and CVD, lead investigator Emma Rezel-Potts, PhD, a research associate in Translational Epidemiology and Public Health at Kings College London, told Drug Topics®.

“We know that COVID-19 is not just a respiratory infection but a multi-system disease. The virus is believed to trigger events which can affect multiple systems in the body, including a dysregulated immune response and cell dysfunction.”

In DM, the finding might be related to direct infection of SARS-CoV-2 in pancreatic cells, Rezel-Potts said. “It could also be the case that COVID-19 reduces physical activity, leading to greater insulin resistance. Contacts with medical care may also lead to increased opportunities to detect previously undiagnosed diabetes,” she added.

It is also interesting to note that CVD risk is so highly elevated during acute-COVID-19 before a rapid decline, whereas DM risk is very high initially and then remains elevated by 27% from 4 to 12 weeks,” Rezel-Potts said.

However, the timeframe fits with what researchers know about how these conditions typically present, Rezel-Potts explained. "Cardiovascular conditions are associated with acute presentations that may lead to early diagnosis, whereas diabetes can vary in the time it takes to be diagnosed,” she said.

Clinical and public health interventions focusing on reducing diabetes risk among those recovering from COVID-19 over the longer-term may be very beneficial, Rezel-Potts said.

“The information provided by this very large population-based study on the longer-term effects of COVID-19 on development of cardiovascular conditions and diabetes will be extremely valuable to doctors managing the millions of people who have had COVID-19 by now,” added study investigator Ajay Shah, M.D., executive dean of the Faculty of Life Sciences and Medicine and the British Heart Foundation, in the statement. “It is clear that particular vigilance is required for at least the first 3 months after COVID-19.”

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