Covid increases chances of developing diabetes and cardiovascular disease, says study

Patients with Covid-19 had a higher risk of developing diabetes and cardiovascular disease even months after the infection was diagnosed, suggests a study published on Tuesday (19). For some complications, the occurrence was 11 times higher among people who had Covid compared to those who were not infected with the coronavirus.

The relationship between Covid and these health complications had already been observed in other studies. Evidence indicates that Sars-CoV-2 causes more serious conditions in those who do not have controlled diabetes, exemplifies Domingos Malerbi, president of the diabetes mellitus department at Sbem (Brazilian Society of Endocrinology and Metabology) and who did not participate in the study.

In the new research, which was published in the journal Plos Medicine and is signed by researchers from England, data from the European country were used to compare patients who tested positive for Covid with others who did not contract the disease. The two groups – each with around 428,000 participants – were followed up until January of this year.

The study measured the incidence of complications in three phases according to the diagnosis of Covid: acute (up to four weeks of the viral infection record), post-acute (from 5 to 12 weeks) and long (from 13 to 52 weeks). Then, the researchers observed the onset of diabetes or cardiovascular disease at these three times.

In the case of diabetes, an 81% increase in the condition in the acute phase of Covid was recorded in patients who had the infection compared to those who did not contract Sars-CoV-2.

In the post-acute Covid period, the highest incidence was 27% in patients diagnosed with the infection. In the longer period, there was no increase when comparing the groups.

Malerbi says there are some reasons to understand the effects of Sars-CoV-2 on the onset of diabetes. One is that the virus affects the pancreatic islet, which is where insulin is produced. This scenario causes the lack of control of the blood glucose level in the body and can cause the disease.

Another explanation is when the virus does not act directly on the islet, but causes an immune system response that affects the pancreas. “There is a whole immunological modification and this can trigger an autoimmune process in which the individual produces antibodies against the islet. He attacks himself”, says Malerbi.

A third hypothesis is related to corticosteroids, drugs used to control inflammatory processes. Malerbi says they “are a factor that can trigger a disease or even exacerbate a preexisting condition.” At Covid, these medicines are indicated for serious conditions and, therefore, may be associated with the appearance of diabetes in these patients.

cardiovascular complications

The research followed the same methodology to understand the incidence of cardiovascular complications from Covid: long-term monitoring of the appearance of conditions in patients with and without the diagnosis of viral infection.

In the end, complications were seen six times more in patients who had Covid. For some conditions, however, the index was even higher. For example, pulmonary embolism – where pulmonary arteries are blocked – was present about 11 times more often in those who tested positive for Sars-CoV-2.

“In the first cases, the person was discharged from Covid and then hospitalized for pulmonary embolism”, recalls Maria Cristina Izar, director of Socesp (Sociedade de Cardiologia do Estado de São Paulo), about clinical conditions she observed from Covid and that shortly after developed the cardiovascular complication.

Izar, who did not participate in the research, points out that a possible explanation for this phenomenon is the cytokine storm – an immune response that seeks to fight the Covid infection, but causes problems for the body.

One such damage is to endothelial cells. They produce substances that act for the full functioning of blood vessels. The cytokine storm damages these cells, which can lead to problems such as pulmonary embolism.

Cardiovascular complications were mainly seen in the period of acute Covid. After the fourth week, the risks dropped and returned to the normal level in the long Covid phase – from the 12th week.

This result is close to that seen in the case of diabetes. With this, the researchers concluded that, if there are no pre-existing risk factors, Covid does not impact the appearance of the conditions in the long term.

medical surveillance

The study’s findings lead the authors to advocate for physicians to advise patients who have Covid. That is, it is important to guide people to be attentive to the appearance of other complications in the medium term.

Malerbi says vigilance is necessary. According to him, it is recommended to do exams between 60 to 90 days after the end of Covid symptoms, even if it was a mild condition.

Izar also points out that it is advisable to adopt some habits that can avoid health complications after Covid. Among them, the main ones would be a healthy diet, avoid smoking and the practice of physical activities.