Long term health outcomes in people with diabetes 12 months after hospitalisation with COVID-19 in the UK: a prospective cohort study.
Gharibzadeh S., Routen A., Razieh C., Zaccardi F., Lawson C., Gillies C., Heller S., Davies M., Atkins H., Bain SC., Lone NL., Poinasamy K., Peto T., Robertson E., Young B., Johnston D., Quint J., Valabhji J., Ismail K., Marks M., Horsley A., Docherty A., Harrison E., Chalmers J., Ho L-P., Raman B., Brightling C., Elneima O., Evans R., Greening N., Harris VC., Houchen-Wolloff L., Sereno M., Shikotra A., Singapuri A., Wain L., Langenberg C., Dennis J., Petrie J., Sattar N., Leavy O., Richardson M., Saunders RM., McArdle A., McASuley H., Yates T., Khunti K., PHOSP-COVID Study Collaborative Group None.
BACKGROUND: People with diabetes are at increased risk of hospitalisation, morbidity, and mortality following SARS-CoV-2 infection. Long-term outcomes for people with diabetes previously hospitalised with COVID-19 are, however, unknown. This study aimed to determine the longer-term physical and mental health effects of COVID-19 in people with and without diabetes. METHODS: The PHOSP-COVID study is a multicentre, long-term follow-up study of adults discharged from hospital between 1 February 2020 and 31 March 2021 in the UK following COVID-19, involving detailed assessment at 5 and 12 months after discharge. The association between diabetes status and outcomes were explored using multivariable linear and logistic regressions. FINDINGS: People with diabetes who survived hospital admission with COVID-19 display worse physical outcomes compared to those without diabetes at 5- and 12-month follow-up. People with diabetes displayed higher fatigue (only at 5 months), frailty, lower physical performance, and health-related quality of life and poorer cognitive function. Differences in outcomes between diabetes status groups were largely consistent from 5 to 12-months. In regression models, differences at 5 and 12 months were attenuated after adjustment for BMI and presence of other long-term conditions. INTERPRETATION: People with diabetes reported worse physical outcomes up to 12 months after hospital discharge with COVID-19 compared to those without diabetes. These data support the need to reduce inequalities in long-term physical and mental health effects of SARS-CoV-2 infection in people with diabetes. FUNDING: UK Research and Innovation and National Institute for Health Research. The study was approved by the Leeds West Research Ethics Committee (20/YH/0225) and is registered on the ISRCTN Registry (ISRCTN10980107).