For a study, researchers sought to determine the post-acute risk and burden of incident diabetes in people who survived the first 30 days after contracting SARS-CoV-2. They used the US Department of Veterans Affairs’ national databases to create a cohort of 181,280 participants who had a positive COVID-19 test between March 1, 2020, and September 30, 2021 and survived the first 30 days of COVID-19; a contemporary control (n=4,118,441) who enrolled participants between March 1, 2020, and September 30, 2021; and a historical control (n=4,286,911) who enrolled participants between March 1, 2018, and September 30, 2019. SARS-CoV-2 infection was not found in any of the control groups. Before joining the cohort, all three comparison groups were free of diabetes, and they were monitored for a median of 352 days. To assess post-acute COVID-19 risks of incident diabetes, antihyperglycemic use, and a composite of the 2 outcomes, investigators performed inverse probability-weighted survival analyses with specified and algorithmically selected high dimensional factors. At 12 months, they reported 2 risk measures: hazard ratio (HR) and burden per 1,000 persons. In the post-acute phase of the disease, people with COVID-19 had a higher risk of incident diabetes (HR 1.40, 95% CI 136–1444) and an excess burden of incident antihyperglycemic usage (13.46, 95% CI 12.11–14.84, per 1000 people at 12 months) compared to the current control group.

Furthermore, investigations to quantify the risk of a composite endpoint of incident diabetes or antihyperglycemic usage at 12 months indicated an HR of 1.46 (95% CI 1.43–1.50) and an excess burden of 18.03 (95% CI 16.59–19.51) per 1,000 persons. The intensity of COVID-19’s acute phase raised the risks and burdens of post-acute outcomes in a graded manner (whether patients were non-hospitalized, hospitalized, or admitted to intensive care). All results were consistent in studies employing the historical control as the reference category. In the post-acute phase, the study group found that people with COVID-19 had higher risks and 12-month burdens of incident diabetes and antihyperglycemic use when compared to a current control group of people who were enrolled during the same period and had not contracted SARS-CoV-2, and a historical control group from before the pandemic. Diabetes should be identified and managed as part of post-acute COVID-19 treatment.