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Patients with T2D underwent assessments with the NICE post-COVID questionnaire, DN4 questionnaire, vibration perception threshold (VPT), and corneal confocal microscopy (CCM) before and 11.0\u2009\u00b1\u20098.9 months after developing COVID-19. Of 76 participants with T2D, 35 (46.1%) developed COVID-19, of whom 8 (22.9%) developed severe COVID-19 and 9 (25.7%) developed long-COVID. The development of COVID-19 was associated with lower systolic blood pressure (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The presence and severity of DPN were not associated with developing COVID-19, severe COVID-19, or long-COVID (<jats:italic>P<\/jats:italic>\u2009=\u20090.42\u20130.94). Women were eight times more likely to develop long-COVID (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) and elevated body weight, LDL, and VPT were associated with the development of long-COVID (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05\u2009\u2212\u20090.01). The long-COVID group exhibited significant changes in triglycerides and LDL\u00a0(<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05\u00a0for both) and body weight (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) at follow-up. Their impact on clinical and neuropathy measures was comparable in patients with and without COVID-19 (<jats:italic>P<\/jats:italic>\u2009=\u20090.08\u20130.99). There was a significant reduction in corneal nerve measures (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05-0.0001) in patients with and without COVID-19. A low systolic blood pressure, altered lipids, body weight, higher VPT,\u00a0and gender may determine the impact of COVID-19 in patients with T2D, but there was no evidence of an impact of COVID-19 on the development or progression of DPN.<\/jats:p>","DOI":"10.1038\/s41598-025-95133-4","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T07:01:34Z","timestamp":1743663694000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 and neuropathy in type 2 diabetes"],"prefix":"10.1038","volume":"15","author":[{"given":"Georgios","family":"Ponirakis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Al-Janahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Einas","family":"Elgassim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aisha","family":"Al Obaidan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoda","family":"Gad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis N.","family":"Petropoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadeel B.","family":"Zaghloul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamda","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mashhood A.","family":"Siddique","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima F. 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