Abstract
Aims. To test the hypothesis that COVID-19 status increases the incidence of new hypertension (HTN) and chronic kidney disease (CKD) in patients with type-2 diabetes (T2D).
Methods. This retrospective study consisted of 46448 patients with T2D from the Montefiore Health System in the Bronx (3/01/2020–7/01/2023), of which 13801 had a positive COVID-19 test. Contemporary controls included those hospitalized for other lower-respiratory-tract infections (LRTI, n=1638) and nonhospitalized patients without COVID-19 or LRTI (n=32647). Outcomes were assessed at follow-up (2 months to 3 years) relative to baseline. Adjusted odds ratio (aOR) were computed.
Results. The cumulative incidences of HTN (HR=1.84, 95% CI [1.34, 2.22], p<0.001) and CKD (HR=1.97, 95% CI [1.57, 2.43], p<0.001) were significantly higher in non-hospitalized COVID-19 compared to non-COVID-19 patients, but not between patients hospitalized for COVID-19 and LRTI (p>0.05). Non-hospitalized COVID-19 patients had higher odds of developing HTN compared to non-COVID patients during all follow-up (aOR 1.99, 95% CI [1.54, 2.57], p<0.001), but hospitalized COVID-19 patients had similar odds of developing HTN relative to patients hospitalized for LRTI (aOR 1.26, 95% CI [0.70, 2.27], p=0.441). Non-hospitalized COVID-19 patients had higher odds of developing CKD compared to non-COVID patients during all follow-up (aOR 2.09, 95% CI [1.69, 2.76], p<0.001), but hospitalized COVID-19 patients had similar odds of developing CKD relative to patients hospitalized for LRTI (aOR 0.96, 95% CI [0.79, 1.36], p=0.131).
Conclusions. T2D patients with COVID-19 were at higher risk of developing new disorders compared to their counterparts. Identifying individuals at-risk could help manage long COVID-19 disorders in T2D patients.