Risk of Incident Diabetes after COVID-19 Infection
Coronavirus disease 2019 (COVID-19)
is one of the most significant pandemics in human history caused by the virus
known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
SARS-CoV-2 has infected >530 million people, of which >6.3 million have
died since June 23, 2022.
Recent research has indicated that
COVID-19 might be a risk factor for various chronic diseases, which means new
health problems will be added to the already tough ones.
Both pre-existing diabetes and
new-onset diabetes after infection are important factors in increasing the risk
of serious adverse outcomes (e.g. acute respiratory distress syndrome,
intensive care unit admission, mechanical ventilation use, death) in patients
with COVID-19.
Increased incidence of diabetes has
been reported in patients following a COVID-19 diagnosis. Both type 1 diabetes
(T1D) and type 2 diabetes (T2D) may be induced by COVID-19, although the
underlying mechanisms have not been fully explored.
TAKE-HOME MESSAGE
This systematic review and
meta-analysis sought to determine the relative risk of incident diabetes in
patients with COVID-19.
Based on 11 retrospective cohorts
involving 47,120,129 participants, primarily from the United States and Europe,
authors found that COVID-19 was associated with a 64 % increased risk of overall
diabetes.
The magnitude of the effect of
COVID-19 on T2D was significantly greater than that on T1D. The risk was also
consistent compared with the historical controls and respiratory infection
controls.
There was a 64% greater risk of
diabetes in patients with COVID-19 compared with non-COVID controls.
The relative risk of type 2
diabetes was higher than that of type 1 diabetes. Men were found to be at a
higher risk than women.
In summary, there is a significant association between COVID-19 infection
and the development of diabetes in the general population.
This highlights the extraordinary importance of raising awareness of the
risk of diabetes in patients with COVID-19 and identifying potential factors
that influence the risk.
Therefore, the management, prevention, and screening of diabetes in COVID-19 survivors should be strengthened.
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BACKGROUND
COVID-19 might be a risk factor for
various chronic diseases. However, the association between COVID-19 and the
risk of incident diabetes remains unclear. We aimed to meta-analyze evidence on
the relative risk of incident diabetes in patients with COVID-19.
METHODS
In this systematic review and
meta-analysis, the Embase, PubMed, CENTRAL, and Web of Science databases were
searched from December 2019 to June 8, 2022. We included cohort studies that
provided data on the number, proportion, or relative risk of diabetes after
confirming the COVID-19 diagnosis. Two reviewers independently screened studies
for eligibility, extracted data, and assessed risk of bias. We used a
random-effects meta-analysis to pool the relative risk with corresponding 95%
confidence intervals. Prespecified subgroup and meta-regression analyses were
conducted to explore the potential influencing factors. We converted the
relative risk to the absolute risk difference to present the evidence. This
study was registered in advance.
MAIN FINDINGS
Ten articles involving 11
retrospective cohorts with a total of 47.1 million participants proved
eligible. We found a 64 % greater risk of diabetes in patients with
COVID-19 compared with non-COVID-19 controls, which could increase the number
of diabetes events by 701 (558 more to 865 more) per 10,000 persons. We
detected significant subgroup effects for type of diabetes and sex. Type 2
diabetes has a higher relative risk than type 1. Moreover, men may be at a
higher risk of overall diabetes than women. Sensitivity analysis confirmed the
robustness of the results. No evidence was found for publication bias.
CONCLUSIONS
COVID-19 is strongly associated
with the risk of incident diabetes, including both type 1 and type 2 diabetes.
We should be aware of the risk of developing diabetes after COVID-19 and
prepare for the associated health problems, given the large and growing number
of people infected with COVID-19. However, the body of evidence still needs to
be strengthened.
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