Holman Naomi, Barron Emma, Young Bob, Gregg Edward W, Khunti Kamlesh, Valabhji Jonathan, Sattar Naveed
1School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, U.K.
2Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.
Diabetes Care. 2023 May 1;46(5):938-943. doi: 10.2337/dc22-0670.
The incidence of diabetes may be elevated following coronavirus disease 2019 (COVID-19), but it is unclear whether this is specific to severe acute respiratory syndrome coronavirus 2 infection, associated with shared risk factors for severe COVID-19 and diabetes, and/or a generic risk following illness.
People admitted to the hospital for COVID-19 and/or pneumonia between 1 April 2020 and 31 August 2020 in England were linked with the National Diabetes Audit to identify incident diabetes after discharge up to 31 March 2021. Comparator cohorts admitted with pneumonia over the same dates in 2017, 2018, and 2019 were followed until 31 March 2018, 31 March 2019, and 31 March 2020, respectively. Poisson regression models were used to calculate adjusted diabetes incidence rates.
Using the cohort of people discharged from the hospital following a diagnosis of COVID-19 without pneumonia in 2020 as the standard population (incidence rate 16.4 [95% CI 12.8-20.7] per 1,000 person-years), adjusting for age, sex, ethnicity, and deprivation, gave incidence rates of 19.0 (95% CI 13.8-25.6) and 16.6 (95% CI 13.3-20.4) per 1,000 person-years for those admitted for COVID-19 with pneumonia and pneumonia without COVID-19, respectively, in 2020. These rates are not significantly different from those found after hospital admission for pneumonia in 2019, 2018, and 2017, at 13.7 (95% CI 10.8-17.3), 13.8 (95% CI 10.9-17.4), and 14.2 (95% CI 10.9-18.3) per 1,000 person-years, respectively.
Our data do not support a clear impact of COVID-19 on the incidence of diabetes compared with risks in several comparator groups, including contemporaneously assessed risks in people hospitalized with pneumonia.
2019冠状病毒病（COVID-19）后糖尿病发病率可能升高，但尚不清楚这是否特定于严重急性呼吸综合征冠状病毒2感染，是否与严重COVID-19和糖尿病的共同风险因素相关，以及/或者是疾病后的一般风险。
将2020年4月1日至2020年8月31日期间因COVID-19和/或肺炎入住英格兰医院的患者与国家糖尿病审计数据相联系，以确定截至2021年3月31日出院后的新发糖尿病病例。对2017年、2018年和2019年同一日期因肺炎入院的对照队列分别随访至2018年3月31日、2019年3月31日和2020年3月31日。采用泊松回归模型计算调整后的糖尿病发病率。
以2020年诊断为COVID-19但无肺炎的出院患者队列作为标准人群（发病率为每1000人年16.4[95%CI 12.8 - 20.7]），在调整年龄、性别、种族和贫困程度后，2020年因COVID-19合并肺炎入院患者和因肺炎但无COVID-19入院患者的发病率分别为每1000人年19.0（95%CI 13.8 - 25.6）和16.6（95%CI 13.3 - 20.4）。这些发病率与2019年、2018年和2017年因肺炎入院后的发病率相比无显著差异，2019年、2018年和2017年的发病率分别为每1000人年13.7（95%CI 10.8 - 17.3）、13.8（95%CI 10.9 - 17.4）和14.2（95%CI 10.9 - 18.3）。
与几个对照队列的风险相比（包括同期评估的肺炎住院患者的风险），我们的数据不支持COVID-19对糖尿病发病率有明显影响。
