Patients who contract COVID-19 face a higher risk of developing cardiovascular diseases and diabetes, particularly in the three months after infection, according to a recent British study.
Scientists are increasingly recognising COVID-19 as a multi-system condition that can cause disease throughout the body, possibly by triggering pathways that cause inflammation.
In the latest study by researchers Emma Rezel-Potts, Martin Gulliford and colleagues of King’s College London, they investigated whether a sample of COVID-19 patients developed new cases of diabetes and cardiovascular diseases at higher rates than a sample of people who have never had the disease in the year after infection.
They analysed anonymised medical records from more than 428,000 COVID-19 patients, and the same number of control individuals, matched by age, sex and family practice. The analysis showed that COVID-19 patients had 81% more diagnoses of diabetes in the first four weeks after contracting the virus and that their risk remained elevated by 27% for up to 12 weeks after infection.
COVID-19 was also associated with a six-fold increase in cardiovascular diagnoses overall, mainly due to the development of pulmonary embolism (blood clots in the lungs) and irregular heartbeat. The risk of a new heart disease diagnosis began to decline five weeks after infection and returned to baseline levels or lower within 12 weeks to one year.
The researchers conclude that COVID-19 infection is associated with an increased risk of cardiovascular disorders and diabetes, but fortunately, there does not appear to be a long-term increase in the incidence of these conditions for patients who have contracted the virus.
Based on these findings, which were published in PLOS Medicine, they recommend that doctors advise their patients who are recovering from COVID-19 to reduce their risk of diabetes through a healthy diet and exercise.
Co-author Ajay Shah 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. It is clear that particular vigilance is required for at least the first three months after COVID-19.”
Lead author Emma Rezel-Potts said: “Use of a large, national database of electronic health records from primary care enabled us to characterise the risk of cardiovascular disease and diabetes mellitus during the acute and longer-term phases after COVID-19 infection. While it is in the first four weeks that these 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.”
Study details
Cardiometabolic outcomes up to 12 months after COVID-19 infection. A matched cohort study in the UK
Emma Rezel-Potts, Abdel Douiri, Xiaohui Sun, Phillip Chowienczyk, Ajay Shah, Martin Gulliford.
Published in PLOS Medicine on 19 July 2022
Abstract
Background
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.
Methods and findings
We conducted a cohort study from 2020 to 2021 analysing electronic records for 1,356 United Kingdom family practices with a population of 13.4m. Participants were 428,650 COVID-19 patients without DM or CVD who were individually matched with 428,650 control patients on age, sex, and family practice and followed up to January 2022. Outcomes were incidence of DM and CVD. A difference-in-difference analysis estimated the net effect of COVID-19 allowing for baseline differences, age, ethnicity, smoking, body mass index (BMI), systolic blood pressure, Charlson score, index month, and matched set. Follow-up time was divided into 4 weeks from index date (“acute COVID-19”), 5 to 12 weeks from index date (“post-acute COVID-19”), and 13 to 52 weeks from index date (“long COVID19”). Net incidence of DM increased in the first 4 weeks after COVID-19 (adjusted rate ratio, RR 1.81, 95% confidence interval (CI) 1.51 to 2.19) and remained elevated from 5 to 12 weeks (RR 1.27, 1.11 to 1.46) but not from 13 to 52 weeks overall (1.07, 0.99 to 1.16). Acute COVID-19 was associated with net increased CVD incidence (5.82, 4.82 to 7.03) including pulmonary embolism (RR 11.51, 7.07 to 18.73), atrial arrythmias (6.44, 4.17 to 9.96), and venous thromboses (5.43, 3.27 to 9.01). CVD incidence declined from 5 to 12 weeks (RR 1.49, 1.28 to 1.73) and showed a net decrease from 13 to 52 weeks (0.80, 0.73 to 0.88). The analyses were based on health records data and participants’ exposure and outcome status might have been misclassified.
Conclusions
In this study, we found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks after 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.
See more from MedicalBrief archives:
Long COVID can trigger type 2 diabetes in some – VA cohort study
Long COVID impacts heart, lung and kidney – Scottish study
COVID-19 link to 5x higher risk of thrombotic events – Swedish cohort study
Global database for research to examine link between COVID-19 and diabetes