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

• Published in: Nature metabolism Vol. 3; no. 6; pp. 774 - 785
• Main Authors: Montefusco, Laura, Ben Nasr, Moufida, D'Addio, Francesca, Loretelli, Cristian, Rossi, Antonio, Pastore, Ida, Daniele, Giuseppe, Abdelsalam, Ahmed, Maestroni, Anna, Dell'Acqua, Marco, Ippolito, Elio, Assi, Emma, Usuelli, Vera, Seelam, Andy Joe, Fiorina, Roberta Maria, Chebat, Enrica, Morpurgo, Paola, Lunati, Maria Elena, Bolla, Andrea Mario, Finzi, Giovanna, Abdi, Reza, Bonventre, Joseph V, Rusconi, Stefano, Riva, Agostino, Corradi, Domenico, Santus, Pierachille, Nebuloni, Manuela, Folli, Franco, Zuccotti, Gian Vincenzo, Galli, Massimo, Fiorina, Paolo
• Format: Journal Article
• Language: English
• Published: Germany Nature Publishing Group 01.06.2021
• Subjects: Antigens; Beta cells; Blood Glucose - metabolism; Clinical outcomes; Cohort Studies; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - virology; Cytokines; Diabetes; Diabetes mellitus; Enzymes; Fasting; Glucose metabolism; Glucose monitoring; Hemoglobin; Homeostasis; Humans; Hyperglycemia; Hyperglycemia - complications; Hyperglycemia - metabolism; Insulin Resistance; Insulin-Secreting Cells - pathology; Intensive care; Mortality; Patients; SARS-CoV-2 - isolation & purification; Severe acute respiratory syndrome coronavirus 2; Variance analysis; Ventilators
• ISSN: 2522-5812
• DOI: 10.1038/s42255-021-00407-6

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.