Studies Suggest Links Between COVID-19 and Diabetes, Pregnancy Risks and Dementia
The most obvious risks from COVID-19 are hospitalization and death. But study after study shows the disease comes with an increased risk of a number of health problems, including diabetes. One of the best ways to avoid those risks is to get vaccinated. Read on for more details.
COVID-19 Increases Risk of Type 2 Diabetes
Being diabetic is one of the clear health conditions associated with a greater risk of COVID-19. But what is starting to emerge from the data is that people infected with COVID-19 were at greater risk of developing type 2 diabetes within a year compared to people who did not contract COVID-19. The large cohort study was published in The Lancet Diabetes & Endocrinology and looked at national databases of the U.S. Department of Veterans Affairs to evaluate 181,280 participants who tested positive for COVID-19 between March 1, 2020 and September 30, 2021, and survived the first 30 days of COVID-19. They then used a contemporary control of 4,118,441 people and a historical control of 4,286,911, that had no history of COVID-19 infection. Participants in all three cohorts were "free of diabetes before cohort entry and were followed up for a median of 352 days."
The study found that even mild infection increased the risk of new-onset type 2 diabetes, although the risk increased with the severity of COVID-19 symptoms. The study doesn't demonstrate cause and effect but suggests a strong association between COVID-19 infection and type 2 diabetes. The bottom line was that people diagnosed with COVID-19 were 46% more likely to develop type 2 diabetes for the first time or to be prescribed drugs to control their blood sugar. Another way of looking at it is 2 in 100 COVID-19 patients have a greater likelihood of developing type 2 diabetes.
"For the broader public, if you've had COVID-19, you need to pay attention to your blood sugar," said Ziyad Al-Aly, chief of research and development at VA St. Louis Health Care System, who led the review.
Although VA patients are typically older than the general population, with a greater percentage of Whites and males, the risk was seen in all subgroups, including women, racial minorities, younger people and individuals with varying body mass indexes.
COVID-19 Doubles Risk of Negative Outcomes in Pregnant Women
A new study published in JAMA Internal Medicine demonstrated that pregnant women with COVID-19 had more than twice the risk of negative outcomes than pregnant women who did not contract the disease. Those outcomes included preterm birth, blood clots, respiratory distress syndrome and sepsis. The study, conducted by Kaiser Permanente, analyzed the data of more than 43,000 pregnant women during the first year of the pandemic.
"These findings add to the growing evidence that having COVID-19 during pregnancy raises risks of serious complications," stated Dr. Assiamira Ferrara, lead author and senior research scientist and associate director of the women's and children's health section in the Kaiser Permanente Division of Research. "Coupled with the evidence that the COVID-19 vaccines are safe during pregnancy, these findings should aid patients in understanding the risks of perinatal complications and the need for vaccination."
Does COVID-19 Increase the Risk of Dementia?
It's clear that there can be neurological side effects from COVID-19, the so-called "brain fog" associated with some cases as well as with Long Covid. Long Covid is described as "not recovering [for] several weeks or months following the start of symptoms that were suggestive of COVID, whether you were tested or not." Of course, the most common symptoms are respiratory — shortness of breath, coughing — as well as fatigue and joint pain. And other respiratory viruses are associated with neurological and psychiatric side effects related to infection of the peripheral and CNS cells and inflammatory cascades.
Researchers are studying whether COVID-19's neurocognitive effects are permanent or may increase dementia risk. Although the data is a long way from being definitive, studies suggest that in some cases, COVID-19 infection patients have blood-cerebrospinal fluid barrier dysfunction, which allows the virus to infect the nerves and brain. To date, the data is not conclusive.
Prof. Harris Gelbard, director of the Center for Neurotherapeutics Discovery at the University of Rochester Medical Center, told Medical News Today, "The pathological evidence for direct infection of neural cell types, particularly neurons, remain[s] equivocal at best."
Others suspect that the factors contributing to dementia, such as high blood pressure and diabetes, also make them more susceptible to COVID-19. And data does suggest that people with dementia are at almost double the risk of contracting COVID-19 than people without dementia.
COVID-19 Increases Risk of Heart Problems
It is well-established that respiratory infections, not just COVID-19, can trigger heart disease. This occurs because the viruses cause inflammation, which is a major factor in cardiovascular disease. And COVID-19 is no different. The disease increases the likelihood of cardiovascular disease, even in people with mild disease. A large study published in Nature Medicine found that even mild disease created a higher risk of heart problems one year after infection.
Ziyad Al-Aly, co-author and chief of research and development at VA St. Louis Health Care System, said, "I went into this assuming there was going to be some risk, but primarily in people who had very severe disease and needed to be hospitalized in the acute phase of the infection."
Instead, they found the risk of any heart complication over one year after infection was 63% higher than people in the contemporary control group. The cardiovascular events included stroke or heart failure at a rate of 45 per 1,000 people who tested positive for COVID-19.
COVID-19 and Long-Term Lung Damage
It would make sense that a largely respiratory illness like COVID-19 would increase the risk of long-term damage to the lungs. And Long Covid appears to occur in 7 to 18% of people with symptomatic COVID-19. Long-term effects of viral pneumonia vary depending upon the direct injury caused by the virus and the immune reaction to it. Broadly, there appears to be two patterns of lung damage: constrictive bronchiolitis (small airway disease) and diffuse alveolar damage (DAD), which is scarring or fibrosis to the alveoli, the tiny balloon-like structures at the end of the bronchioles. Both appear in a study of COVID-19 patients out of the University of Iowa.
Dr. Alejandro P. Comellas, senior author and professor of medicine in the Division of Pulmonary and Critical Care Medicine and the Carver College of Medicine, University of Iowa, said, "The results provide evidence, quantitatively and qualitatively, of airway damage many months after the initial SARS-CoV-2 infection, including patients who were initially treated in the ambulatory setting. Despite expected pulmonary functions tests in the ambulatory patients, 30% of their lungs had evidence of small airway disease." And for some patients, that was more than six months post-infection.