Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection

Nat Metab. 2021 Jun;3(6):774-785. doi: 10.1038/s42255-021-00407-6. Epub 2021 May 25.

Abstract

Patients with coronavirus disease 2019 (COVID-19) are reported to have a greater prevalence of hyperglycaemia. Cytokine release as a consequence of severe acute respiratory syndrome coronavirus 2 infection may precipitate the onset of metabolic alterations by affecting glucose homeostasis. Here we describe abnormalities in glycometabolic control, insulin resistance and beta cell function in patients with COVID-19 without any pre-existing history or diagnosis of diabetes, and document glycaemic abnormalities in recovered patients 2 months after onset of disease. In a cohort of 551 patients hospitalized for COVID-19 in Italy, we found that 46% of patients were hyperglycaemic, whereas 27% were normoglycaemic. Using clinical assays and continuous glucose monitoring in a subset of patients, we detected altered glycometabolic control, with insulin resistance and an abnormal cytokine profile, even in normoglycaemic patients. Glycaemic abnormalities can be detected for at least 2 months in patients who recovered from COVID-19. Our data demonstrate that COVID-19 is associated with aberrant glycometabolic control, which can persist even after recovery, suggesting that further investigation of metabolic abnormalities in the context of long COVID is warranted.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism*
  • COVID-19 / blood*
  • COVID-19 / complications
  • COVID-19 / virology
  • Cohort Studies
  • Humans
  • Hyperglycemia / complications
  • Hyperglycemia / metabolism*
  • Insulin Resistance
  • Insulin-Secreting Cells / pathology
  • SARS-CoV-2 / isolation & purification

Substances

  • Blood Glucose