Mary Wilson
Well-known member
August 9, 2023
doi: https://doi.org/10.1101/2023.08.07.23293778
Kurt Taylor1*, Sophie Eastwood2*, Venexia Walker1,3,4*, Genevieve Cezard5,6, Rochelle Knight1,3,7, 8, Marwa Al Arab1, Yinghui Wei9, Elsie M F Horne1,7, Lucy Teece10, Harriet Forbes11, Alex Walker12, Louis Fisher12, Jon Massey12, Lisa E M Hopcroft12, Tom Palmer1,2, Jose Cuitun Coronado1, Samantha Ip5,6, Simon Davy12, Iain Dillingham12, Caroline Morton12, Felix Greaves13,14, John Macleod1,7,8, Ben Goldacre12, Angela Wood5,6,15,16,17,18, Nishi Chaturvedi2^, Jonathan A C Sterne1,7,19^*, Rachel Denholm1,7,19^
Abstract
Background
Type 2 diabetes (T2DM) incidence is increased after diagnosis of COVID-19. The impact of vaccination on this increase, for how long it persists, and the effect of COVID-19 on other types of diabetes remain unclear.
Methods
With NHS England approval, we studied diabetes incidence following COVID-19 diagnosis in pre- vaccination (N=15,211,471, January 2020-December 2021), vaccinated (N =11,822,640), and unvaccinated (N=2,851,183) cohorts (June-December 2021), using linked electronic health records. We estimated adjusted hazard ratios (aHRs) comparing diabetes incidence post-COVID-19 diagnosis with incidence before or without diagnosis up to 102 weeks post-diagnosis. Results were stratified by COVID- 19 severity (hospitalised/non-hospitalised) and diabetes type.
Findings
In the pre-vaccination cohort, aHRS for T2DM incidence after COVID-19 (compared to before or without diagnosis) declined from 3.01 (95% CI: 2.76,3.28) in weeks 1-4 to 1.24 (1.12,1.38) in weeks 53-102. aHRS were higher in unvaccinated than vaccinated people (4.86 (3.69,6.41)) versus 1.42 (1.24,1.62) in weeks 1-4) and for hospitalised COVID-19 (pre-vaccination cohort 21.1 (18.8,23.7) in weeks 1-4 declining to 2.04 (1.65,2.51) in weeks 52-102), than non-hospitalised COVID-19 (1.45 (1.27,1.64) in weeks 1-4, 1.10 (0.98,1.23) in weeks 52-102). T2DM persisted for 4 months after COVID-19 for ~73% of those diagnosed. Patterns were similar for Type 1 diabetes, though excess incidence did not persist beyond a year post- COVID-19.
Interpretation
Elevated T2DM incidence after COVID-19 is greater, and persists longer, in hospitalised than non- hospitalised people. It is markedly less apparent post-vaccination. Testing for T2DM after severe COVID- 19 and promotion of vaccination are important tools in addressing this public health problem.
https://www.medrxiv.org/content/10.1101/2023.08.07.23293778v1.full.pdf
doi: https://doi.org/10.1101/2023.08.07.23293778
Kurt Taylor1*, Sophie Eastwood2*, Venexia Walker1,3,4*, Genevieve Cezard5,6, Rochelle Knight1,3,7, 8, Marwa Al Arab1, Yinghui Wei9, Elsie M F Horne1,7, Lucy Teece10, Harriet Forbes11, Alex Walker12, Louis Fisher12, Jon Massey12, Lisa E M Hopcroft12, Tom Palmer1,2, Jose Cuitun Coronado1, Samantha Ip5,6, Simon Davy12, Iain Dillingham12, Caroline Morton12, Felix Greaves13,14, John Macleod1,7,8, Ben Goldacre12, Angela Wood5,6,15,16,17,18, Nishi Chaturvedi2^, Jonathan A C Sterne1,7,19^*, Rachel Denholm1,7,19^
Abstract
Background
Type 2 diabetes (T2DM) incidence is increased after diagnosis of COVID-19. The impact of vaccination on this increase, for how long it persists, and the effect of COVID-19 on other types of diabetes remain unclear.
Methods
With NHS England approval, we studied diabetes incidence following COVID-19 diagnosis in pre- vaccination (N=15,211,471, January 2020-December 2021), vaccinated (N =11,822,640), and unvaccinated (N=2,851,183) cohorts (June-December 2021), using linked electronic health records. We estimated adjusted hazard ratios (aHRs) comparing diabetes incidence post-COVID-19 diagnosis with incidence before or without diagnosis up to 102 weeks post-diagnosis. Results were stratified by COVID- 19 severity (hospitalised/non-hospitalised) and diabetes type.
Findings
In the pre-vaccination cohort, aHRS for T2DM incidence after COVID-19 (compared to before or without diagnosis) declined from 3.01 (95% CI: 2.76,3.28) in weeks 1-4 to 1.24 (1.12,1.38) in weeks 53-102. aHRS were higher in unvaccinated than vaccinated people (4.86 (3.69,6.41)) versus 1.42 (1.24,1.62) in weeks 1-4) and for hospitalised COVID-19 (pre-vaccination cohort 21.1 (18.8,23.7) in weeks 1-4 declining to 2.04 (1.65,2.51) in weeks 52-102), than non-hospitalised COVID-19 (1.45 (1.27,1.64) in weeks 1-4, 1.10 (0.98,1.23) in weeks 52-102). T2DM persisted for 4 months after COVID-19 for ~73% of those diagnosed. Patterns were similar for Type 1 diabetes, though excess incidence did not persist beyond a year post- COVID-19.
Interpretation
Elevated T2DM incidence after COVID-19 is greater, and persists longer, in hospitalised than non- hospitalised people. It is markedly less apparent post-vaccination. Testing for T2DM after severe COVID- 19 and promotion of vaccination are important tools in addressing this public health problem.
https://www.medrxiv.org/content/10.1101/2023.08.07.23293778v1.full.pdf