We know that having co-morbid conditions such as asthma, heart disease, diabetes, and others are risk factors for significant COVID-19 disease and death. Now, independent reports out of the US and the UK strongly suggest that having COVID-19 can also lead to the swift onset of diabetes, even in people with mild infections. This includes children. These observations add to the list of long-term health problems for the millions of COVID-19 survivors living with chronic conditions following infection called "long-haulers."
Some 10-30% of COVID-19 survivors develop persistent and sometimes debilitating symptoms after apparent recovery from the disease. It has been known for a few months that in a subset of these long-haulers, lingering metabolic complications require high doses of insulin suggesting that they are developing diabetes. This possible link between COVID-19 and new-onset diabetes was noticed as early as last summer and was reported in Scientific American last February. Two more recent analyses of patient data strengthen the COVID-diabetes link.
- In the US, researchers at the Veterans Affairs St Louis Health Care System’s clinical epidemiology center recently published their findings in the journal, Nature. They used data from VA national health-care databases and found that COVID-19 survivors were about 39% more likely to have a new diabetes diagnosis six months after infection compared to non-infected users of the VA health system. This means that there about 6.5 extra diabetes cases per 1000 COVID-19 patients who are not hospitalized. For hospitalized patients, the risk jumped 5-fold to 37 per 1000, and it is even higher for patients who required intensive care.
- In the UK, a study of 50,000 hospitalized COVID patients was published about three weeks earlier than the US study. The UK study reported that the patients were 50% more likely to develop diabetes 20 weeks after discharge than matched control patients.
How does the virus do this? CoV-2 primarily is a respiratory disease, but we have known since the early days of the pandemic that it also can ravage other organs including the kidneys, brain, and others. The leading theory of how COVID-19 can cause diabetes is that the pancreas, where insulin is produced, also can be damaged by the virus, or by the immune inflammatory response that follows infection. Other possible mechanisms are also being considered.
Bottom line: As of this month, 153 million people around the world have been infected with the virus. That means that the pandemic has caused a LOT of new cases of diabetes, a chronic disease, for the world to absorb. To monitor global COVID-related diabetes, a world-wide registry has been set up by King’s College London and Monash University in Melbourne. Almost 500 doctors around the world so far have agreed to share data via the registry.
Maybe this information will convince people who down play the disease by only focusing on the low mortality rate of COVID-19 that they also need to consider the accompanying long-term health consequences of the disease.