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

on behalf of the N3C Consortium

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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 bal-anced on demographic characteristics, comorbidities, and medications used to treat diabetes. The primary outcome was the postindex average HbA1c and post-index 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.

Original languageEnglish (US)
Pages (from-to)2709-2717
Number of pages9
JournalDiabetes care
Issue number11
StatePublished - Nov 2022

Bibliographical note

Funding Information:
Acknowledgments. The authors are thankful for contributions from the following: N3C Publication Committee, Data Access Committee, Download Request Committee, and N3C Diabetes and Obesity Domain Team. The analyses described in this publication were conducted with data or tools accessed through the National Center for Advancing Translational Sciences N3C Data Enclave (covid.cd2h. org/enclave). This research was possible because of the patients whose information is included within the data from participating organizations (covid.cd2h.org/dtas) and the organizations and scientists (covid.cd2h.org/ duas) who have contributed to the ongoing development of this community resource (20). A full list of Acknowledgments can be found in the Appendix. Funding. This work was supported by National Center for Advancing Translational Sciences (NCATS) grant U24 TR002306 (R.W., R.V., M.A.H., R.M.). J.S.T. was supported, in part, by National Institutes of Health/National Institute of Diabetes, Digestive, and Kidney Diseases Mentored Patient Oriented Research Award (K23DK116935). J.B.B. was supported in part by grants from the National Institutes of Health (NCATS grant UL1TR002489 and Foundation for the National Institutes of Health grant P30DK124723). T.S. receives investigator-initiated research funding and support as principal investigator (R01 AG056479) from the National Institute on Aging and as coinvestigator (R01 HL118255, R01 MD011680), National Institutes of Health. He also receives salary support as Director of Comparative Effectiveness Research, NC TraCS Institute, UNC Clinical and Translational Science Award (UL1TR002489). Duality of Interest. T.S. receives salary support from the Center for Pharmacoepidemiology (current members: GlaxoSmithKline, UCB BioSciences, Takeda, AbbVie, and Boehringer Ingelheim) and from a generous contribution from Dr. Nancy A. Dreyer of IQVia to the Department of Epidemiology, University of North Carolina at Chapel Hill. T.S. does not accept personal compensation of any kind from any pharmaceutical company. He owns stock in Novartis, Roche, and Novo Nordisk. J.S.T. discloses receiving investigator-initiated grant support from Novo Nordisk on behalf of the Trustees of the University of Pennsylvania. J.D.M. reports consulting fees from MannKind and Medtronic Diabetes. He receives investigator-initiated research funding from Dexcom. J.B.B.’s effort is contracted for consulting and clinical trials by the University of North Carolina by Novo Nordisk, Dexcom, Sanofi, Tolerion, and vTv Therapeutics; he has received compensation for consulting from Alkahest, Altimmune, Anji, AstraZeneca, Bayer, Biomea Fusion, Boehringer Ingelheim, CeQur, Cirius Therapeutics, Dasman Diabetes Institute and Research Center (Kuwait City, Kuwait), Eli Lilly, Fortress Biotech, GentiBio, Glycadia, Glyscend, Janssen, Lilly, MannKind, Medi-flix, MedImmune, Medscape, Mellitus Health, Mod-erna, Pendulum Therapeutics, Praetego, Stability Health, Valo, and Zealand Pharma; and he has stock/options in Glyscend, Mellitus Health, Pendulum Therapeutics, PhaseBio, Praetego, and Stability Health. No other potential conflicts of interest relevant to this article were reported.

Publisher Copyright:
© 2022 by the American Diabetes Association.


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