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Multicenter Study
. 2022 Nov 1;45(11):2709-2717.
doi: 10.2337/dc22-0730.

Effect of SARS-CoV-2 Infection and Infection Severity on Longer-Term Glycemic Control and Weight in People With Type 2 Diabetes

Rachel Wong  1 , Rohith Vaddavalli  2 , Margaret A Hall  1 , Monil V Patel  3 , Carolyn T Bramante  4 , Elena Casarighi  5   6 , Steven G Johnson  7 , Veena Lingam  1 , Joshua D Miller  8 , Jane Reusch  9 , Mary Saltz  1 , Til Stürmer  10 , Jena S Tronieri  11 , Kenneth J Wilkins  12 , John B Buse  13   14 , Joel Saltz  1 , Jared D Huling  15 , Richard Moffitt  1 ; N3C Consortium:
Collaborators, Affiliations
Multicenter Study

Effect of SARS-CoV-2 Infection and Infection Severity on Longer-Term Glycemic Control and Weight in People With Type 2 Diabetes

Rachel Wong et al. Diabetes Care. .

Abstract

Objective: To evaluate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severity of infection with longer-term glycemic control and weight in people with type 2 diabetes (T2D) in the U.S.

Research design and methods: We conducted a retrospective cohort study using longitudinal electronic health record data of patients with SARS-CoV-2 infection from the National COVID Cohort Collaborative (N3C). Patients were ≥18 years old with an ICD-10 diagnosis of T2D and at least one HbA1c and weight measurement prior to and after an index date of their first coronavirus disease 2019 (COVID-19) diagnosis or negative SARS-CoV-2 test. We used propensity scores to identify a matched cohort balanced on demographic characteristics, comorbidities, and medications used to treat diabetes. The primary outcome was the postindex average HbA1c and postindex average weight over a 1 year time period beginning 90 days after the index date among patients who did and did not have SARS-CoV-2 infection. Secondary outcomes were postindex average HbA1c and weight in patients who required hospitalization or mechanical ventilation.

Results: There was no significant difference in the postindex average HbA1c or weight in patients who had SARS-CoV-2 infection compared with control subjects. Mechanical ventilation was associated with a decrease in average HbA1c after COVID-19.

Conclusions: In a multicenter cohort of patients in the U.S. with preexisting T2D, there was no significant change in longer-term average HbA1c or weight among patients who had COVID-19. Mechanical ventilation was associated with a decrease in HbA1c after COVID-19.

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Figures

Figure 1
Figure 1
Distribution of percent change in average HbA1c (A) and weight (B) in COVID-19 and control groups.
Figure 2
Figure 2
Forest plot showing adjusted coefficients for postindex HbA1c in COVID-19 and control patients with T2D (n = 6,003). Age is presented in years. GLP-1, glucagon-like peptide 1; ref, reference; SGLT2, sodium–glucose cotransporter 2.
Figure 3
Figure 3
Forest plot showing adjusted coefficients for postindex weight in COVID-19 and control patients with T2D (n = 6,003). Age is presented in years. GLP-1, glucagon-like peptide 1; ref, reference; ref, reference; SGLT2, sodium–glucose cotransporter 2.
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