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Objective <p>To examine whether pre-pandemic diabetes is associated with an increased risk of Long COVID in a nationally representative UK cohort.</p> Methods <p>We conducted a prospective cohort analysis using data from the UK Household Longitudinal Study. A total of 11,669 adults aged ≥ 16 years were followed from Wave 10 (2018–19) to Wave 14 (2022–23). The primary exposure, pre-pandemic diabetes, was defined at baseline (Wave 10) based on self-report of a doctor diagnosis. The primary outcome, Long COVID, was assessed at follow-up (Wave 14) and defined as self-reported symptoms lasting more than 12 weeks after a COVID-19 infection that could not be explained by another cause. Modified Poisson regression models with robust standard errors were used to estimate relative risks of Long COVID associated with pre-pandemic diabetes. Predictive margins were then calculated to obtain adjusted probabilities.</p> Results <p>At follow-up, 1,076 participants (9.2%) reported Long COVID. In the unadjusted model, participants with pre-pandemic diabetes had a 36% higher risk of Long COVID compared with those without diabetes (RR = 1.36, 95% CI: 1.09–1.69, <i>p</i> = 0.006). After adjusting for age and sex, the relative risk increased to 1.43 (95% CI: 1.15–1.79, <i>p</i> = 0.002). In the fully adjusted model, which controlled for age, sex, ethnicity, education, income satisfaction, smoking, and other long-standing illness, the relative risk of Long COVID in participants with diabetes was 1.60 (95% CI: 1.27–2.02, <i>p</i> &lt; 0.001). The adjusted predicted probability of long COVID was 14.4% (95% CI: 11.2–17.6) among those with diabetes, compared with 9.0% (95% CI: 8.5–9.5) among those without.</p> Conclusions <p>In this nationally representative prospective cohort, pre-pandemic diabetes emerged as an independent risk factor for Long COVID. Enhanced surveillance and targeted support for individuals with diabetes may be warranted in Long COVID care strategies.</p>

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Pre-pandemic diabetes and risk of long COVID: longitudinal evidence

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月19日

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  • Yusuff Adebayo Adebisi,
  • Anas Ali Alhur,
  • Najim Z. Alshahrani,
  • Victor C. Cañezo Jr.,
  • Edgar G. Cue,
  • Don Eliseo Lucero-Prisno III

摘要

Objective

To examine whether pre-pandemic diabetes is associated with an increased risk of Long COVID in a nationally representative UK cohort.

Methods

We conducted a prospective cohort analysis using data from the UK Household Longitudinal Study. A total of 11,669 adults aged ≥ 16 years were followed from Wave 10 (2018–19) to Wave 14 (2022–23). The primary exposure, pre-pandemic diabetes, was defined at baseline (Wave 10) based on self-report of a doctor diagnosis. The primary outcome, Long COVID, was assessed at follow-up (Wave 14) and defined as self-reported symptoms lasting more than 12 weeks after a COVID-19 infection that could not be explained by another cause. Modified Poisson regression models with robust standard errors were used to estimate relative risks of Long COVID associated with pre-pandemic diabetes. Predictive margins were then calculated to obtain adjusted probabilities.

Results

At follow-up, 1,076 participants (9.2%) reported Long COVID. In the unadjusted model, participants with pre-pandemic diabetes had a 36% higher risk of Long COVID compared with those without diabetes (RR = 1.36, 95% CI: 1.09–1.69, p = 0.006). After adjusting for age and sex, the relative risk increased to 1.43 (95% CI: 1.15–1.79, p = 0.002). In the fully adjusted model, which controlled for age, sex, ethnicity, education, income satisfaction, smoking, and other long-standing illness, the relative risk of Long COVID in participants with diabetes was 1.60 (95% CI: 1.27–2.02, p < 0.001). The adjusted predicted probability of long COVID was 14.4% (95% CI: 11.2–17.6) among those with diabetes, compared with 9.0% (95% CI: 8.5–9.5) among those without.

Conclusions

In this nationally representative prospective cohort, pre-pandemic diabetes emerged as an independent risk factor for Long COVID. Enhanced surveillance and targeted support for individuals with diabetes may be warranted in Long COVID care strategies.