London—Recovering COVID-19 patients are at higher risk of developing CVD or diabetes, especially in the first 3 months following infection, according to a new study.
The UK researchers from Kings College London noted, "Acute Coronavirus Disease 2019 (COVID-19) has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls."
To answer that question, the study team conducted a cohort study from 2020 to 2021 analyzing electronic records for 1,356 UK family practices with a population of 13.4 million. The study included 428,650 COVID-19 patients without DM or CVD who were individually matched with 428,650 control patients on age, sex, and family practice. Follow-up continued until January 2022.
"Use of a large, national database of electronic health records from primary care has enabled us to characterize the risk of cardiovascular disease and diabetes mellitus during the acute and longer-term phases following COVID-19 infection," stated lead author Emma Rezel-Potts, PhD. "Whilst it is in the first four weeks that COVID-19 patients are most at risk of these outcomes, the risk of diabetes mellitus remains increased for at least 12 weeks. Clinical and public health interventions focusing on reducing diabetes risk among those recovering from COVID-19 over the longer term may be very beneficial."
Results published in PLOS Medicine indicated that the net incidence of DM increased in the first 4 weeks after COVID-19 (adjusted rate ratio, RR 1.81, 95% CI 1.51-2.19) and remained elevated from 5 to 12 weeks (RR 1.27, 1.1-1.46) but not from 13 to 52 weeks overall (1.07, 0.99-1.16).
In addition, the study found that acute COVID-19 was associated with net increased CVD incidence (5.82, 4.82-7.03), including pulmonary embolism (RR 11.51, 7.07-18.73), atrial arrhythmias (6.44, 4.17-9.96), and venous thromboses (5.43, 3.27-9.01). "CVD incidence declined from 5 to 12 weeks (RR 1.49, 1.28-1.73) and showed a net decrease from 13 to 52 weeks (0.80, 0.73-0.88)," the researchers pointed out.
"In this study, we found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses," the authors wrote. "DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions."
Even though the authors reported an association between an increased risk of CVD and DM, they did not find a long-term increase in the incidence of the conditions after COVID-19 infection. Based on those findings, they recommended that healthcare professionals advise patients who are recovering from COVID-19 to reduce their risk of diabetes through a healthy diet and exercise.
"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. It is clear that particular vigilance is required for at least the first 3 months after COVID-19," stated coauthor Ajay M. Shah, MD.
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