Patients with type 1 diabetes are at elevated risk of developing new hypertension, chronic kidney disease and diabetic ketoacidosis after COVID‐19: Up to 40 months’ follow‐up

Abstract

AbstractAimThe aim was to investigate whether COVID‐19 increases new incidence of hypertension (HTN), chronic kidney disease (CKD) and diabetic ketoacidosis (DKA) in patients with type 1 diabetes (T1D) up to 40 months post‐infection.Materials and MethodsThree groups of patients from the Montefiore Health System in the Bronx (1 March 2020 to 1 July 2023) were studied: T1D patients hospitalized for COVID‐19 (H‐COVID‐19, n = 511), T1D patients with COVID‐19 but not hospitalized for COVID‐19 (NH‐COVID‐19, n = 306) and T1D patients without a positive COVID‐19 test on record (non‐COVID‐19, n = 1547). COVID‐19 patients were those with a positive polymerase‐chain‐reaction test on record, and non‐COVID‐19 patients were either tested negative or not tested on record. Cumulative incidences and adjusted hazard ratios (aHR) with 95% confidence intervals (CI) were computed with adjustment for competing risks.ResultsCompared to non‐COVID‐19 patients, both H‐COVID‐19 (unadjusted 19.72% vs. 3.14%, p < 0.001; aHR = 7.55 [3.33, 17.06], p < 0.001) and NH‐COVID‐19 (10.26% vs. 3.14%, p = 0.004; aHR = 5.08 [2.19, 11.78], p < 0.001) patients were more likely to develop new HTN. Compared to non‐COVID‐19 patients, both H‐COVID‐19 (11.41% vs. 1.14%, p < 0.001; aHR = 9.76 [4.248, 22.25], p < 0.001) and NH‐COVID‐19 (7.69% vs. 1.14%, p < 0.001; aHR = 6.54 [2.91, 14.67], p < 0.001) patients were more likely to develop new CKD. Compared to non‐COVID‐19 patients, both H‐COVID‐19 (4.09% vs. 1.06%, p < 0.001; aHR = 12.24 [4.09, 36.59], p < 0.001) and NH‐COVID‐19 (3.06% vs. 1.06%, p = 0.035; aHR = 12.94 [4.09, 40.89], p < 0.001) patients were more likely to develop new DKA at follow‐up.ConclusionT1D patients with COVID‐19 are at higher risk of developing new HTN, CKD and DKA compared to T1D patients without COVID‐19.