{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:50:08Z","timestamp":1791996608285,"version":"4.4.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":187,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Expert Rev. Mol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1462399426100647_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accumulating evidence suggests that long COVID (LC) is mediated by chronic immune activation, oxidative stress and metabolic dysregulation. These processes may impair glucose homeostasis and promote insulin resistance (IR). However, no prior meta-analysis has systematically and quantitatively evaluated IR indices and related biomarkers in LC compared with normal controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1462399426100647_sec2\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically review and meta-analyse IR indices including HOMA-IR, HOMA-%B, HOMA-%S, insulin, fasting and random blood sugar (FBG, RBS), glycated haemoglobin (HbA1c), C-peptide and adipokine levels in individuals with LC compared with normal controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1462399426100647_sec3\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, SCOPUS, SciFinder and Google Scholar databases were searched for relevant studies from inception to September 2025. Fifty-six eligible studies were included, comprising 9623 participants, 5340 LC patients and 4283 normal controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1462399426100647_sec4\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LC disease is characterized by elevated HOMA-IR (standardized mean difference, SMD\u00a0=\u00a00.539; 95% confidence interval, CI: 0.311; 0.766), insulin (SMD\u00a0=\u00a00.424; 95% CI: 0.113; 0.735), FBG and RBS (SMD\u00a0=\u00a00.734; 95% CI: 0.190; 1.277, SMD\u00a0=\u00a00.325; 95% CI: 0.133; 0.517). Furthermore, reduced HOMA-%S was observed in LC patients versus normal controls. Publication bias was generally low, though evidence of small-study effects was observed for several outcomes. The Immunological Confounder Scale was employed to evaluate study quality, revealing an overall intermediate methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1462399426100647_sec5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results show that LC is associated with multiple abnormalities in glucose homeostasis, including increased HOMA-IR, hyperglycaemia and impaired insulin sensitivity indices, sustained metabolic disturbances beyond the acute phase.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/erm.2026.10064","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:48:06Z","timestamp":1783403286000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Increased Insulin Resistance and Hyperglycaemia in Long COVID: A Systematic Review and Meta-Analysis"],"prefix":"10.1017","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7667-6731","authenticated-orcid":false,"given":"Abbas F.","family":"Almulla","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qr3zq92","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Electronic Science and Technology of China"},{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Chinese Academy of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingqian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chulalongkorn University"},{"name":"Chulalongkorn University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chavit","family":"Tunvirachaisakul","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Deakin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre F.","family":"Carvalho","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qr3zq92","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Electronic Science and Technology of China"},{"id":[{"id":"https:\/\/ror.org\/028wp3y58","id-type":"ROR","asserted-by":"publisher"}],"name":"Chinese Academy of Medical Sciences"},{"name":"Chulalongkorn University"},{"name":"Medical University of Plovdiv"},{"name":"Medical University of Plovdiv"},{"name":"Kyung Hee University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2012-871X","authenticated-orcid":false,"given":"Michael","family":"Maes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qr3zq92","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Electronic Science and Technology of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,7]]},"container-title":["Expert Reviews in Molecular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1462399426100647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:14:30Z","timestamp":1785482070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1462399426100647\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"alternative-id":["S1462399426100647"],"URL":"https:\/\/doi.org\/10.1017\/erm.2026.10064","relation":{},"ISSN":["1462-3994"],"issn-type":[{"value":"1462-3994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e38"}}