Association of glycemic control with Long COVID in patients with type 2 diabetes: findings from the National COVID Cohort Collaborative (N3C)
Authors' conclusion
Poor glycemic control (HbA1c≥8%) in people with T2D was associated with higher risk of Long COVID symptoms 30-180 days following COVID-19. Notably, this risk increased as HbA1c levels rose. However, this association was not observed in patients with T2D without a history of COVID-19. An NLP-based definition of Long COVID identified more patients than diagnosis codes and should be considered in future studies.
Study context
- Population
- Individuals with T2D and COVID-19 from eight National COVID Cohort Collaborative sites with longitudinal natural language processing (NLP) data; COVID-negative group as controlCOVID-positive
- Participants
- 7,430 individuals
- Exposure
- HbA1c ranges vs HbA1c 6.5% to <8%
- Outcome
- Death or new-onset recurrent Long COVID symptoms
- Follow-up
- 30-180 days after COVID-19
Methodological detailselectronic health record data, eight sites, NLP-identified symptoms, COVID-negative control group
- Electronic health record data
- Eight sites
- NLP-identified symptoms
- COVID-negative control group
Main finding
As reported in the abstract
Death or Long COVID
Each group vs HbA1c 6.5% to <8%Odds ratio (95% CI)
HbA1c 8% to <10%
1.20(1.02–1.41)
HbA1c ≥10%
1.40(1.14–1.72)
Observational data: associations, not effects.
Further findings
Long COVID and death in COVID-positive cohort · 30-180 days
- Developed symptomatic Long COVID
- 1491 (20.1%)
- Died
- 380 (5.1%)
Long COVID symptoms
- Higher HbA1c associated with increased risk of Long COVID symptoms, especially respiratory and brain fog
Death · 30-180 days following COVID-19
- No association between HbA1c levels and risk of death
NLP vs diagnosis codes
- NLP identified more patients with Long COVID symptoms than diagnosis codes
Original publication
Association of glycemic control with Long COVID in patients with type 2 diabetes: findings from the National COVID Cohort Collaborative (N3C). BMJ Open Diabetes Res Care. Published 4 February 2025. doi:10.
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