Diabetogenic risk of malaria in recovered covid-19 Respondents compared to uninfected covid-19 Respondents in the tamale metropolis

Abstract

The emergence of COVID-19 has heightened interest in how the illness interacts with common comorbidities including malaria and type 2 diabetes mellitus (T2DM). COVID-19 infection has been associated with new-onset hyperglycaemia and T2DM, as well as a worsening of glycaemic control in non-diabetics without a history of diabetes and diabetics due to direct pancreatic damage and the cytokine onslaught in response to the infection. This cross-sectional study evaluated COVID- 19 recovered persons with or without malaria for their likelihood of developing T2DM. Two hundred and ninety non-COVID-19 and COVID-19 confirmed participants with or without malaria were recruited from the public health reference laboratory database in the Northern region of Ghana. Respondents were assessed for fasting blood glucose (FBG), beta cell function, C-reactive protein (CRP), insulin resistance (IR), malondialdehyde (MDA), and malaria parasitaemia. Beta cell function and IR were calculated using the Homeostatic models for assessment of IR (HOMA-IR) and beta cell function (HOMA-B) formulae. COVID-19 recovered respondents exhibited significantly higher mean levels for HOMA-IR (7.1 ± 8.1 vs 3.7 ± 2.9 mIU/L; P<0.001), FBG (4.95 ± 1.13 vs 4.26 ± 0.58 mmol/l; P<0.001), and CRP (1.35 ±1.41 vs 0.99 ± 0.88 mg/dl; P=0.0098) compared to the control respondents. The total prevalence of HOMA-IR in cases was 38.3% compared to 32.4% in the control respondents. A binary logistic regression analysis of beta cell activity, insulin, CRP, MDA, and malaria found that study participants with malaria had a greater risk of developing hyperinsulinemia than participants without malaria in both groups. Mean values of the other indices were comparable between the groups. The findings of the study demonstrate that COVID-19, through insulin resistance, can contribute to the risk of T2DM development in recovered COVID-19 respondents.