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

Abstract

Abstract Aim The 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 Methods Three 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. Results Compared to non‐COVID‐19 patients, both H‐COVID‐19 (unadjusted 19.72% vs. 3.14%, p &lt; 0.001; aHR = 7.55 [3.33, 17.06], p &lt; 0.001) and NH‐COVID‐19 (10.26% vs. 3.14%, p = 0.004; aHR = 5.08 [2.19, 11.78], p &lt; 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 &lt; 0.001; aHR = 9.76 [4.248, 22.25], p &lt; 0.001) and NH‐COVID‐19 (7.69% vs. 1.14%, p &lt; 0.001; aHR = 6.54 [2.91, 14.67], p &lt; 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 &lt; 0.001; aHR = 12.24 [4.09, 36.59], p &lt; 0.001) and NH‐COVID‐19 (3.06% vs. 1.06%, p = 0.035; aHR = 12.94 [4.09, 40.89], p &lt; 0.001) patients were more likely to develop new DKA at follow‐up. Conclusion T1D patients with COVID‐19 are at higher risk of developing new HTN, CKD and DKA compared to T1D patients without COVID‐19.