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The increased risk of diabetes after COVID-19 infection continues into Omicron’s time, but vaccination against SARS-CoV-2 appears to reduce that likelihood, new data suggest.
Findings from more than 20,000 patients at the Cedars-Sinai Health System in Los Angeles, California say, “Continued efforts to prevent COVID-19 infection will continue until we better understand the potential long-term effects. The long-term effects of COVID-19,” said Alan C. Kwan, MD, lead author in the Department of Cardiology, Smidt Heart Institute at Cedars Sinai. said. Medscape Medical News.
Several studies conducted early in the pandemic suggested an increased risk of both new onset diabetes and cardiometabolic disease It may be due to persistent inflammation after COVID-19 infection. insulin resistance.
However, it is not clear whether these risks persist with the recent predominance of less virulent Omicron variants, or whether the COVID-19 vaccine influences the risks. This new study suggests that both are true.
“Our results demonstrate the risk of developing the disease. type 2 diabetes “Post-COVID-19 isn’t just an early observation, it’s actually a real risk that, unfortunately, persisted throughout the Omicron era,” said Kwan.
“While the level of evidence from our study and others may not be at the level needed to influence formal guidelines at this time, clinical suspicion of diabetes mellitus following COVID-19 infection may be lacking. increased, and we think it’s reasonable that the threshold for testing has been lowered,” he added.
Furthermore, “Our study and others suggest a potential role for COVID-19 in influencing cardiovascular risk, so it is recommended that reasonable personal practices and vaccinations reduce the risk of COVID-19 infection. We believe that this suggests both prevention of cancer and increased interest in cardiovascular health after COVID-19 infection is justified.”
Here are the findings: publish online February 14 JAMA network open.
Diabetes risk after COVID-19 persists, reduced with vaccination
Kwan et al. analyzed data from a total of 23,709 patients (inpatients and outpatients) who received treatment for at least one COVID-19 infection between March 2020 and June 2022.
new incidence of diabetes (using ICD-10 codes, primarily type 2 diabetes), high blood pressure, and hyperlipidemia were all elevated 90 days after COVID-19 infection compared to the previous 90 days. The same was true for two diagnoses unrelated to COVID-19, urinary tract infection and urinary tract infection. gastroesophageal refluxused as a benchmark for healthcare engagement.
Diabetes mellitus had the highest post-infection and pre-infection odds (odds ratio [OR]2.35; P. < .001), followed by hypertension (OR, 1.54; P. < .001), benchmark diagnostics (OR, 1.42; P. < .001), and hyperlipidemia (OR, 1.22; P. = .03).
After adjustment, the risk of new-onset diabetes pre- and post-COVID-19 versus benchmark conditions increased significantly (OR, 11.58; P. < .001), hypertension and hyperlipidemia risk relative to benchmark diagnosis was not (OR, 11.06; P. = .52 and 0.91, P. = .43, respectively).
Post-COVID-19 and pre-infection diabetes risk was higher among unvaccinated individuals (OR, 1.78; P. < .001) vaccinated (OR, 1.07; P. = .80).
However, there was no significant interaction between vaccination and diabetes diagnosis (P. = .08). “For this reason, we believe our data suggest a protective effect in pre-infection vaccinated populations. [this is] It’s not definitive,” Kwan said.
There was no apparent interaction by age, gender, or pre-existing conditions cardiovascular risk factors, including hypertension or hyperlipidemia. Age, sex, and timing of first infection for the omicron variant were not associated with increased risk of new cardiometabolic diagnoses before or after COVID-19 infection in any model.
Kwan said Medscape Medical News: “We continue to be amazed by the progress we have made in understanding the SARS-Cov-2 virus and its impact on human health. In the early days of the pandemic, it was considered a purely respiratory virus. However, it is now known to be a serious virus, with limited explanations for all of its potential effects on humans. We believe this raises concerns about the increase.
“Knowledge on this topic is incomplete, but clinical providers may wish to have a higher suspicion of both diabetes and the risk of future cardiac events in patients post-COVID-19,” said Dr. Until we better understand the implications of COVID’s potential long-term effects, continued efforts to prevent it will benefit patient health.”
This research was funded by grants from the Erika J. Glazer Family Foundation, the Doris Duke Charitable Foundation, and the National Institutes of Health. Kwan reports receiving a grant from the Doris Duke Charitable Foundation while conducting research.
JAMA net opened. Published online on February 14, 2023. overview
Miriam E. Tucker is a freelance journalist based in Washington, DC. She is a regular contributor to her Medscape, and her other work appears in her The Washington Post, her Shots blog on NPR, and Diabetes Forecast magazine. She uses @MiriamETucker on her Twitter.
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