Diabetic patients who contract COVID-19 tend to recover more slowly, experience complications of COVID-19 for longer, have a lower quality of life, and require closer and longer-term monitoring by their medical team. This was demonstrated in a University of São Paulo study that followed 870 people for up to seven months after hospitalization. The study was published in the journal scientific report.
Diabetes is not only a risk factor for the acute phase of COVID-19 infection. It has also been shown to prolong recovery time and impair quality of life in the long term. This study makes it abundantly clear that diabetic patients infected with COVID-19 need a healthcare framework to prevent these survivors from falling into a cycle of hospital readmissions. ”
Maria Elizabeth Rossi da Silva, one of the study authors
Mr. Silva heads the Diabetes Department at Das Clinic Hospital (HC), a hospital complex managed by the University of São Paulo Faculty of Medicine (FM-USP) in Brazil.
The study found that people with diabetes took longer to recover from the virus and were at higher risk of cardiovascular complications such as heart attack and angina than non-diabetics. Seven months after discharge, the diabetic group had increased levels of frailty, higher incidence of falls, and poorer quality of life. They experienced mobility difficulties, inability to perform daily activities, and decreased performance in physical and cognitive domains.
The study compared 320 people with diabetes and 550 people without diabetes. This is part of a larger study supported by FAPESP that recruited more than 3,000 people admitted to HC between March and September 2020. This period corresponded to the first phase of the pandemic in Brazil, when a vaccine was not yet available.
Approximately 7 months after discharge, participants underwent a comprehensive in-person evaluation that included a physical examination and laboratory tests.
According to the study results, 94.3% of patients without diabetes reported complete recovery, compared to 89.8% of patients with diabetes. “That’s quite a difference,” Silva says.
Researchers explain that the cardiovascular systems of people with diabetes are under significant stress from the virus. “The systemic inflammation caused by diabetes amplifies the direct virulence of the virus, creating a scenario where the heart becomes one of the main targets for severe complications, and the risk increases with the number of comorbidities a patient has,” she said.
The implications of this cascading effect are far-reaching. Among people with diabetes, the virus significantly impaired exercise capacity. 21% of these patients reported a fall after discharge, nearly double the rate observed in patients without diabetes (11.1%).
“A combination of metabolic changes and longer hospital stays result in longer hospital stays in patients with diabetes (16 days vs 13 days) – creating a cycle of muscle mass loss and fragility, which prevents a return to everyday autonomy,” she told Agência FAPESP.
For Silva, understanding these metabolic peculiarities and the socio-economic challenges of diabetes is essential to clinical care. “Chronic inflammatory conditions associated with diabetes and obesity, as well as accelerated progression of heart and functional damage, make this group more susceptible to severe complications. Additionally, the virus can worsen symptoms by directly affecting pancreatic cells and by causing insulin resistance,” she explains.
She also highlights that social inequalities influence disease outcomes. These inequalities include limited access to health care, stress, unhealthy diets, and lack of time to exercise. “Health policy needs to take these factors into account and provide special follow-up care for people with diabetes in the post-COVID-19 period,” she says.
Another important finding was that 7.3% of participants without diabetes developed the disease after contracting COVID-19. However, while researchers cannot rule out a direct role for the virus in destroying pancreatic cells, they believe it is more likely that an infection revealed pre-existing cases or that a severe inflammatory response triggered the disease in people who were already predisposed.
“This information must be interpreted with caution, because while infections may promote the development of diabetes, the pandemic itself and social isolation may also be influencing factors such as stress, poor diet, lack of physical activity, and obesity, all of which can trigger diabetes,” she says.
A study of patients admitted to HC during the first phase of the pandemic is ongoing, with researchers analyzing data collected three years after infection. “It is important to understand how COVID-19 affects diabetes in the long term,” she says.
sauce:
São Paulo Research Foundation (FAPESP)
Reference magazines:
Lin, C.J. Others. (2026). Diabetes outcomes after COVID-19. scientific report. DOI: 10.1038/s41598-026-42284-7. https://www.nature.com/articles/s41598-026-42284-7
