Patients With Type 2 Diabetes Are at Greater Risk of Developing New Hypertension and Chronic Kidney Disease Following COVID-19.

Abstract

Background: The purpose of this study was to test the hypothesis that COVID-19 status increases the incidence of new hypertension (HTN) and chronic kidney disease (CKD) in patients with Type 2 diabetes (T2D). Methods: This retrospective study consisted of 46,448 patients with T2D from the Montefiore Health System in the Bronx (3/01/2020-7/01/2023), of which 13,801 had a positive COVID-19 test on record. Contemporary controls included those hospitalized for other lower respiratory tract infections (LRTIs) (n = 1638) and nonhospitalized patients without COVID-19 or LRTI (n = 31009). Outcomes were assessed at follow-up (2 months to 3 years) relative to baseline. Adjusted hazards ratios (aHRs) with 95% confidence interval (CI) were computed. Results: The cumulative incidences of HTN (22.32% vs. 9.13%, p < 0.001) and CKD (6.20% vs. 2.03%, p <0.001) were significantly higher in nonhospitalized COVID-19 compared to non-COVID-19 patients, but not between patients hospitalized for COVID-19 and LRTI (p > 0.05). Nonhospitalized COVID-19 patients had higher risk of developing HTN compared to non-COVID patients during all follow-up (aHR 1.99, 95% CI [1.54, 2.57], p < 0.001), but hospitalized COVID-19 patients had similar risk of developing HTN relative to patients hospitalized for LRTI (aHR 1.26 [0.70, 2.27], p = 0.441). Nonhospitalized COVID-19 patients had higher risk of developing CKD compared to non-COVID patients during all follow-up (aHR 2.09 [1.69, 2.76], p < 0.001), but hospitalized COVID-19 patients had similar risk of developing CKD relative to patients hospitalized for LRTI (aHR 0.96 [0.79, 1.36], p = 0.131). Conclusions: T2D patients with COVID-19 were at higher risk of developing new disorders compared with COVID-19-negative controls and were at similar risk compared with those hospitalized for other LRTIs.