Effect of SARS-CoV-2 Infection and Infection Severity on Longer-Term Glycemic Control and Weight in People With Type 2 Diabetes

OBJECTIVE To evaluate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severity of infection with longer-term glycemic control and weight in people with type 2 diabetes (T2D) in the U.S. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study using longitudinal electronic health record data of patients with SARS-CoV-2 infection from the National COVID Cohort Collaborative (N3C). Patients were ‡18 years old with an ICD-10 diagnosis of T2D and at least one HbA_1c and weight measurement prior to and after an index date of their first coronavirus disease 2019 (COVID-19) diagnosis or negative SARS-CoV-2 test. We used propensity scores to identify a matched cohort bal-anced on demographic characteristics, comorbidities, and medications used to treat diabetes. The primary outcome was the postindex average HbA_1c and post-index average weight over a 1 year time period beginning 90 days after the index date among patients who did and did not have SARS-CoV-2 infection. Secondary outcomes were postindex average HbA_1c and weight in patients who required hospitalization or mechanical ventilation. RESULTS There was no significant difference in the postindex average HbA_1c or weight in patients who had SARS-CoV-2 infection compared with control subjects. Mechanical ventilation was associated with a decrease in average HbA_1c after COVID-19. CONCLUSIONS In a multicenter cohort of patients in the U.S. with preexisting T2D, there was no significant change in longer-term average HbA_1c or weight among patients who had COVID-19. Mechanical ventilation was associated with a decrease in HbA_1c after COVID-19.