COVID-19 Raises Hypertension and Kidney Disease Risk in T1D

TOPLINE:

For patients with type 1 diabetes (T1D), a positive test or hospitalization for COVID-19 increases the risk of developing hypertension, chronic kidney disease (CKD), and diabetic ketoacidosis (DKA).

METHODOLOGY:

• Patients with preexisting T1D who acquire SARS-CoV-2 infection are at an increased risk for severe acute COVID-19 outcomes, but the long-term consequences for COVID-19 survivors remain uncertain.
• The researchers aimed to determine whether SARS-CoV-2 infection increases the risk for long-term comorbidities in patients with preexisting T1D from the Montefiore Health System in New York City between March 2020 and July 2023.
• The 2755 patients with preexisting T1D who returned for follow-up were categorized into three groups: Those hospitalized for COVID-19 (n = 456; mean age, 51 years), those with a positive COVID-19 test but not hospitalized (n = 292; mean age, 50 years), and those who tested negative or were not tested in the system (n = 1547; mean age, 37 years).
• The duration of follow-up ranged from 2 to 40 months (median, 18-27 months); the effect of COVID-19 relative to age, sex, race, and preexisting morbidities was analyzed by Cox regression (overlapping demographics included: 46%-54% men, 38%-48% Hispanic, 11%-19% White, 28%-40% Black, and 37%-44% other).
• Primary outcomes included the incidence of newly diagnosed hypertension, CKD, and DKA.

TAKEAWAY:

• Patients with T1D who were hospitalized or tested positive for COVID-19 had a higher incidence of new-onset hypertension (19.72% and 10.26% vs 3.14%), CKD (11.41% and 7.69% vs 1.14%), and DKA (4.09% and 3.06% vs 1.06%) than those without COVID-19.
• Age, race, ethnicity, and some comorbidities showed significant associations of COVID-19 infections with some outcomes.
• In adjusted hazard ratios, those hospitalized for COVID-19 were 7.55 times, 9.76 times, and 12.24 times more likely to develop hypertension, CKD, and DKA, respectively, relative to those without positive tests.
• Those who were not hospitalized for COVID-19 were 5.08 times, 6.54 times, and 12.94 times more likely to develop hypertension, CKD, and DKA, respectively, than those without positive tests.

IN PRACTICE:

“COVID-19 may have latent effects of developing new hypertension, CKD, and DKA,” the authors wrote. “Identification of risk factors associated with new-onset disorders could increase awareness of healthcare providers, thereby ensuring stricter monitoring and improving management of long COVID-19.”

SOURCE:

The study was led by Shiv Mehrotra-Varma, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Centre, New York City. It was published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

This retrospective study was from a single health system in the Bronx and may have unintended selection bias and confounding. The system included a diverse patient population with high proportions of minorities and a lower socioeconomic status, which may limit the generalizability of the findings to less diverse populations. The incidence of some outcomes was small, necessitating cautious interpretation of the results.

DISCLOSURES:

The study did not receive any funding, grants, or additional support. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.