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. 2024 Dec 27:79:103005.
doi: 10.1016/j.eclinm.2024.103005. eCollection 2025 Jan.

Long term health outcomes in people with diabetes 12 months after hospitalisation with COVID-19 in the UK: a prospective cohort study

Safoora Gharibzadeh  1 , Ash Routen  2 , Cameron Razieh  1   3 , Francesco Zaccardi  1 , Claire Lawson  1   4   5   6 , Clare Gillies  1 , Simon Heller  7 , Melanie Davies  5   8 , Helen Atkins  9 , Stephen C Bain  10   11 , Nazir L Lone  12 , Krisnah Poinasamy  13 , Tunde Peto  14 , Elizabeth Robertson  15 , Bob Young  15 , Desmond Johnston  16 , Jennifer Quint  17 , Jonathan Valabhji  18   19   20 , Khalida Ismail  21 , Michael Marks  22   23 , Alex Horsley  24   25 , Annemarie Docherty  12 , Ewen Harrison  12 , James Chalmers  26   27 , Ling-Pei Ho  28 , Betty Raman  29   30 , Chris Brightling  31 , Omer Elneima  31 , Rachel Evans  9   31 , Neil Greening  31 , Victoria C Harris  9 , Linzy Houchen-Wolloff  32 , Marco Sereno  32 , Aarti Shikotra  33 , Amisha Singapuri  31 , Louise Wain  34 , Claudia Langenberg  35 , John Dennis  36 , John Petrie  37   38 , Naveed Sattar  18 , Olivia Leavy  34   31 , Mattew Richardson  31 , Ruth M Saunders  31 , Anne McArdle  39 , Hamish McASuley  31 , Tom Yates  2   4 , Kamlesh Khunti  1 ; PHOSP-COVID Study Collaborative Group
Collaborators, Affiliations

Long term health outcomes in people with diabetes 12 months after hospitalisation with COVID-19 in the UK: a prospective cohort study

Safoora Gharibzadeh et al. EClinicalMedicine. .

Abstract

Background: People with diabetes are at increased risk of hospitalisation, morbidity, and mortality following SARS-CoV-2 infection. Long-term outcomes for people with diabetes previously hospitalised with COVID-19 are, however, unknown. This study aimed to determine the longer-term physical and mental health effects of COVID-19 in people with and without diabetes.

Methods: The PHOSP-COVID study is a multicentre, long-term follow-up study of adults discharged from hospital between 1 February 2020 and 31 March 2021 in the UK following COVID-19, involving detailed assessment at 5 and 12 months after discharge. The association between diabetes status and outcomes were explored using multivariable linear and logistic regressions.

Findings: People with diabetes who survived hospital admission with COVID-19 display worse physical outcomes compared to those without diabetes at 5- and 12-month follow-up. People with diabetes displayed higher fatigue (only at 5 months), frailty, lower physical performance, and health-related quality of life and poorer cognitive function. Differences in outcomes between diabetes status groups were largely consistent from 5 to 12-months. In regression models, differences at 5 and 12 months were attenuated after adjustment for BMI and presence of other long-term conditions.

Interpretation: People with diabetes reported worse physical outcomes up to 12 months after hospital discharge with COVID-19 compared to those without diabetes. These data support the need to reduce inequalities in long-term physical and mental health effects of SARS-CoV-2 infection in people with diabetes.

Funding: UK Research and Innovation and National Institute for Health Research. The study was approved by the Leeds West Research Ethics Committee (20/YH/0225) and is registered on the ISRCTN Registry (ISRCTN10980107).

Keywords: Covid-19; Diabetes; Long Covid.

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Conflict of interest statement

Dr. Gharibzadeh, Dr. Routen, Dr. Gillies, Dr. Harris, Dr. Lone, Dr. Dennis, Dr. Quint, Dr. McAuley, Mr. Sereno, Dr. Elneima, Dr. Saunders, Dr. Houchen-Wolloff, Dr. Razieh, Dr. Ho, Dr. Harrison, Dr. Raman, Dr. Parmar, Dr. Bain, Professor Langenberg, Dr. Peto, Dr. Petrie, Dr. Robertson, Dr. McArdle, Dr. Richardson, Mr. Poinasamy, Dr. Johnston, Ms. Atkins, and Dr Ismail: has nothing to disclose. Dr. Greening: Reports grants from Wellcome Leap, Rejuvenate Biomed, and Eupnoos; grants and personal fees from GSK, Roche/Genentech; and personal fees from Chiesi, Pulmonx, and AstraZeneca, outside the submitted work.; Dr. Zaccardi: Reports personal fees from Menarini and grants and personal fees from Servier, outside the submitted work.; Dr. Yates: Reports grants from NIHR Leicester BRC, during the conduct of the study.; Dr. Chalmers: Reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Genentech, GlaxoSmithKline, Insmed, and Antabio; personal fees from Chiesi, Roche, Zambon, and Pfizer; grants from Grifols, outside the submitted work.; Dr. Singapuri: Reports grants from UKRI & NIHR (Joint funding) during the conduct of the study.; Dr. Docherty: Reports grants from the Wellcome Trust, during the conduct of the study.; Dr. Brightling: Reports grants from NIHR UKRI and Leicester NIHR BRC, during the conduct of the study; grants and personal fees from Areteia, AstraZeneca, Chiesi, Genentech, GlaxoSmithKline, Mologic, Novartis, Regeneron Pharmaceuticals, Roche, and Sanofi, outside the submitted work.; Dr. Lawson: Reports grants from NIHR, during the conduct of the study.; Dr. Marks: Reports grants from DHSC, during the conduct of the study.; Dr. Horsley: Reports grants from the National Institute of Health and Social Care Research (NIHR) Manchester Biomedical Research Centre, during the conduct of the study.; Dr. Wain: Reports grants from UKRI, NIHR, GSK/Asthma + Lung UK during the conduct of the study; grants from Roche, Orion Pharma, and the Wellcome Trust; grants and other support from GSK; other support from Boehringer Ingelheim and Galapagos; personal fees from the European Respiratory Society, outside the submitted work.; Dr. Davies: Reports grants, personal fees, and other support from Boehringer Ingelheim; personal fees and other support from Eli Lilly; grants, personal fees, and other support from Novo Nordisk; other support from Sanofi, Amgen, Biomea Fusion, Carmot, Roche, Zealand Pharma, and Regeneron; and grants, personal fees, and other support from AstraZeneca, outside the submitted work.; Dr. Sattar: Reports personal fees from Abbott Laboratories, AbbVie, Amgen, Hanmi Pharmaceuticals, Janssen, Menarini-Ricerche, Novo Nordisk, and Pfizer; grants and personal fees from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics; personal fees from Sanofi, outside the submitted work.; Professor Jonathan Valabhji: Reports he is National Clinical Lead for Multiple Long-Term Conditions at NHS England and was National Clinical Director for Diabetes and Obesity at NHS England from April 2013 to September 2023.; Dr. Leavy: Reports grants from UKRI and NIHR, during the conduct of the study.; Dr. Heller: Reports other support from Vertex Pharma, Novo Nordisk, Zucara, and Eli Lilly, outside the submitted work.; Dr. Evans: Reports grants from UKRI/MRC/NIHR, personal fees from AstraZeneca/Evidera for Long COVID, and personal fees from Boehringer (June 2021) and Moderna (April 2023) during the conduct of the study; grants from the Wolfson Foundation; and non-financial support from ERS Group 01.02 Pulmonary Rehabilitation and Chronic Care Chair and the ATS Pulmonary Rehabilitation Assembly Chair, outside the submitted work.; Prof. Khunti reports: Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, consulting Fees: Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Lilly, Novo Nordisk, Sanofi, Servier, Pfizer, Roche, Daiichi-Sankyo, Embecta and Nestle Health Science and Grants: AstraZeneca, Boehringer Ingelheim, Lilly, MSD, Novo Nordisk, Roche, Sanofi, Servier, Oramed Pharmaceuticals, Roche, Daiichi-Sankyo, Applied Therapeutics. Bob Young, who has sadly passed away, was included with his family's consent.

Figures

Fig. 1
Fig. 1
Flow diagram of study participants.
See this image and copyright information in PMC

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