Publication date: Sep 01, 2026
COVID-19 has been associated with new-onset diabetes. Prior studies are limited by lack of pre-infection data and preexisting cardiometabolic factors. Clarifying how COVID-19 and long COVID (LC) affect glucose metabolism is essential to guide prevention. We evaluated longitudinal changes in glycemic and cardiometabolic markers after SARS-CoV-2 infection in a prospective cohort with pre-infection baseline measurements. We included 821 uninfected adult participants from the RECOVER cohort who subsequently developed COVID-19, characterizing participants in their pre-COVID state. Data from up to 12 months post-infection were compared to pre-infection baseline. Participants with preexisting diabetes or pregnancy were excluded. The primary endpoint was change in HbA1c up to 12 months after infection. Analysis was stratified by LC status using the 2024 RECOVER Adult Long COVID Research Index (LCRI). HbA1c remained stable from pre-infection to 12 months post-infection (5. 39% vs 5. 40%; P = .435). Non-HDL cholesterol and blood pressure decreased modestly, while cystatin C increased slightly; absolute changes were small. High-sensitivity C-reactive protein (hs-CRP), troponin, pro-brain natriuretic peptide (pro-BNP), body mass index, and waist circumference remained stable. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk increased slightly (6. 7% to 7. 3%; P
| Concepts | Keywords |
|---|---|
| Biomarkers | cardiometabolic disease |
| Covid | COVID-19 |
| Diabetes | inflammation |
| Months | long COVID |
| Pro |
Semantics
| Type | Source | Name |
|---|---|---|
| pathway | REACTOME | Glucose metabolism |
| disease | MESH | COVID-19 |
| disease | MESH | long COVID |
| disease | MESH | infection |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | included |
| drug | DRUGBANK | Nesiritide |
| disease | MESH | metabolic syndrome |
| disease | MESH | inflammation |