SARS-CoV-2 infection poses heightened risk of diabetes

SARS-CoV-2 infection puts individuals at increased risk of developing diabetes, contributing to between 3 percent and 5 percent excess burden of diabetes at a population level, as reported in a study.

For the study, researchers used data from the British Columbia COVID-19 Cohort, a surveillance platform that integrates COVID-19 data with population-based registries and administrative data sets. A total of 629,935 individuals (median age 32 years, 51.2 percent women) who underwent testing for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction (RT-PCR) were included in the analysis.

The primary outcome was incident diabetes, as defined by insulin dependence or nondependence. Diabetes was identified >30 days after the specimen collection date for the SARS-CoV-2 test with a validated algorithm based on medical visits, hospitalization records, chronic disease registry, and prescription drugs for diabetes management.

Of the participants, 125,987 tested positive (exposed) and 503,948 tested negative (unexposed) for SARS-CoV-2. Over a median follow-up of 257 days, incident diabetes was reported among 608 participants in the exposed group and 1,864 in the unexposed group (0.5 percent vs 0.4 percent, respectively). The corresponding incident rate was significantly higher in the exposed group, with 672.2 incidents of diabetes per 100,000 person-years as opposed to 508.7 incidents per 100,000 person-years in the unexposed group (p<0.001).

In multivariable Cox proportional hazard models, exposure to SARS-CoV-2 infection was associated with an increased risk of incident diabetes (hazard ratio [HR], 1.17, 95 percent confidence interval [CI], 1.06–1.28), especially among males (adjusted HR, 1.22, 95 percent CI, 1.06–1.40). The risk increase was also seen among participants with severe disease, including those admitted to the intensive care unit (HR, 3.29, 95 percent CI, 1.98–5.48) or hospital (HR, 2.42, 95 percent CI, 1.87–3.15).

The fraction of incident diabetes cases attributable to SARS-CoV-2 infection was 3.41 percent (95 percent CI, 1.20–5.61) overall and 4.75 percent (95 percent CI, 1.30–8.20) among males.