Long COVID-19 and diabetes mellitus: a short review

Kreutzenberg, Saula Vigili de

doi:10.20517/mtod.2022.30

Cited by 1 publication

(5 citation statements)

References 91 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In acute COVID-19, the most frequent symptoms were fever (60.3%), anosmia/ageusia (52.9%), cough (46.3%), fatigue (43.8%), myalgia (46.3%), headache (42.1%), odynophagia (32.2%), rhinitis (21.5%) and dyspnea (17.4%), with medians of 5 [1][2][3][4][5][6][7][8][9] symptoms and 10 [1-19] days. Grade I symptoms occurred in 21.5%, grade II in 33.6%, and grade III in 44.8% of patients.…”

Section: Baseline Datamentioning

confidence: 99%

“…The most common long-term symptoms are chronic fatigue, persistent dyspnea and shortness of breath, general neurological decay and cognitive dysfunction. This condition, called post-COVID-19 syndrome (PCS), significantly affects patients' quality of life, causes economic and productivity losses and increases the burden of care [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…There is some evidence that PCS is a risk factor for DM [8]. Accumulating results point to several mechanisms that could be implicated: destruction of exocrine and endocrine cells due to SARS-CoV-2 infection, trandifferentiation of pancreatic beta cells through the activation of eIF2 signaling pathway, and induced autoimmunity and low-grade inflammation [4].…”

Section: Introductionmentioning

confidence: 99%

“…Accumulating results point to several mechanisms that could be implicated: destruction of exocrine and endocrine cells due to SARS-CoV-2 infection, trandifferentiation of pancreatic beta cells through the activation of eIF2 signaling pathway, and induced autoimmunity and low-grade inflammation [4]. Of them, IR seems to be a pivotal factor, adscribed to low-grade inflammation [8]. Nevertheless, the pathophysiological and molecular mechanisms connecting PCS and T2DM are far from completely understood [4] and there is a paucity of studies addressing this relation [8].…”

Section: Introductionmentioning

confidence: 99%

“…Of them, IR seems to be a pivotal factor, adscribed to low-grade inflammation [8]. Nevertheless, the pathophysiological and molecular mechanisms connecting PCS and T2DM are far from completely understood [4] and there is a paucity of studies addressing this relation [8]. Additionally, a previous study by our working group showed that subjects with PCS, along with slight but significant elevations of inflammatory markers, had marked sex differences in the inflammatory response [9].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Post-COVID-19 syndrome and insulin resistance 20 months after a mild COVID-19

Fierro

Martin

Rodrigo

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective SARS-CoV-2 infection is associated with impaired glucose metabolism. Although the mechanisms are not fully understood, insulin resistance (IR) appears to be a central factor. Patients who had a severe acute phase, but even asymptomatic or with mild COVID-19, have an increased risk of T2DM. After the acute phase, post-COVID-19 syndrome (PCS) also seems to be related to this metabolic disturbance, but there is a paucity of studies. This study aims to evaluate a possible relationship between PCS and IR after mild COVID-19 and, if confirmed, whether there are differences by sex. Subjects and methods Retrospective observational cohort study including subjects who had mild COVID-19 between April and September 2020 in a community setting. None had been vaccinated against SARS-CoV-2 at inclusion, and previous T2DM and liver disease were exclusion criteria. Patients who met NICE criteria were classified as PCS+. Epidemiological and laboratory data were analysed. Three assessments were performed: 1E (pre-COVID-19, considered baseline and reference for comparisons), 2E (approximately 3 months after the acute phase), and 3E (approximately 20 months after the acute phase). A triglyceride-to-glucose (TyG) index ≥8.74 was considered IR. Albumin-to-globulin ratio (AGR) and lactate dehydrogenase (LDH) were assessed as inflammatory markers. Bivariate analyses were performed, using nonparametric and repeated measures tests. A subsample without metabolic disorder or CVD (age< median, BMI<25 kg/m^2, elevated AGR, TyG index=7.80 [0.5]) was generated to reasonably rule out prior baseline IR that could bias the results. The relationships between PCS and TyG in 3E (TyG3) were modeled in 8 multiple regressions, stratifying by sex and BMI combinations. Results A total of 112 subjects (median [IQR] of age= 44 [20] years; 65 women) were analysed. Up to 14.3% was obese and 17% was hypertensive. Significant increases between 1E and 3E were registered regarding (i) basal glycemia (BG), 87 [14] mg/dL vs. 89 [14]; p=0.014, (ii) TyG index (8.25 [0.8] vs. 8.32 [0.7]; p=0.002), and (iii) LDH in 3rd tertile (16.1% vs 32.1%; p=0.007). A total of 8 previously normoglycemic subjects, showed BG2 or BG3 >126 mg/dL. The subgroups with IR highest prevalence at 3E were those of BMI ≥25 kg/m^2 and PCS+. The subgroup without CVD presented a significant increase in the TyG index (TyG1=7.80 [0.1] vs. TyG3= 8.28 [0.1]; p=0.017). LDH1 was significantly correlated with TyG3 in both sexes (rho=0.214 in women, rho=0.298 in men); in contrast, LDH2 and LDH3 did not present such an association. In multivariable analysis, PCS has shown to be an independent and predictive variable of TyG index in women with BMI<25 kg/m^2, after adjustment for age, hypertension, BMI, Charlson comorbidity index, AGR1, AGR2, LDH1, number of symptoms of acute COVID-19, and number of days of the acute episode (beta coefficient=0.350; p=0.039). Conclusions PCS has played a secondary role in predicting IR, showing a modest effect compared to BMI or prior hypertension. A significant increase in IR has been noted 20 months after mild COVID-19, both in cases of previous baseline IR and in those without previous IR. Basal serum LDH has shown to be predictive of current TyG, regardless of elevated LDH after SARS-CoV-2 infection. There were profound differences between women and men, confirming the need for a sex-stratified analysis when addressing the relation between PCS and glycemic alterations.

show abstract