COVID-19 patients are six times more likely than uninfected people to develop cardiovascular disease (CVD) and nearly twice as likely to receive a new diabetes diagnosis, but the risk begins to recede at 5 weeks and 12 weeks, respectively, concludes a UK study published yesterday in PLOS Medicine.
King's College London researchers analyzed the electronic medical records of 428,650 previously healthy COVID-19 patients and an equal number of matched controls seen at UK family practices from 2020 to 2021. Patients were followed from diagnosis to 4 weeks, 5 to 12 weeks, and 13 to 52 weeks. The median age was 35 years.
81% higher risk of diabetes in first 4 weeks
COVID-19 patients had 81% (adjusted rate ratio [aRR], 1.81; 95% confidence interval [CI], 1.51 to 2.19) more new diabetes diagnoses in the first 4 weeks after infection, and their risk stayed elevated by 27% (aRR, 1.27; 95% CI, 1.11 to 1.46) for up to 12 weeks.
Infection was also tied to a 6-fold increase in new CVD diagnoses, including an 11-fold jump in pulmonary embolism (blood clots in the lungs; aRR, 11.51; 95% CI, 7.07 to 18.73), a 6-fold increase in abnormal heart rhythms (aRR, 6.44; 95% CI, 4.17 to 9.96), and a 5-fold rise in venous thromboses (clots in blood vessels; aRR, 5.43; 95% CI, 3.27 to 9.01). Rates of heart attack (aRR, 2.01; 95% CI, 1.34 to 3.00), heart failure (aRR, 5.23; 95% CI, 2.04 to 13.44), and stroke (aRR, 3.31; 95% CI, 2.05 to 5.35) also increased.
The risk of CVD, however, started to normalize after 5 weeks (aRR, 1.49; 95% CI, 1.28 to 1.73) and returned to baseline or lower within 12 to 52 weeks (aRR, 1.07; 95% CI, 0.99 to 1.16).
Long-term outlook good
The authors noted that SARS-CoV-2 can lead to an outsized immune response and hyperinflammation, platelet activation, a damage to the membrane lining the inside of the heart and blood vessels, and blood clots affecting multiple organs.
Yet they said that the long-term outlook for COVID-19 patients with new CVD or diabetes diagnoses is good. "People without preexisting CVD or [diabetes] who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions," they wrote.
Physicians should advise patients recovering from COVID-19 to lower their odds of developing diabetes through a healthy diet and regular physical activity, the researchers said.
"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," first author Emma Rezel-Potts, PhD, of King's College London, said in a PLOS news release, "Clinical and public health interventions focusing on reducing diabetes risk among those recovering from Covid-19 over the longer-term may be very beneficial."