{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:18:52Z","timestamp":1788153532506,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID-19 has been linked to broad post-acute sequelae, but delayed micronutrient deficiency remains insufficiently characterized. Whether COVID-19 increases long-term risks of laboratory-defined vitamin D, magnesium, and vitamin B12 deficiencies among patients with type 2 diabetes mellitus is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the predominantly US-based TriNetX network, we identified adults with type 2 diabetes mellitus (T2DM) during 2020\u20132022 who had COVID-19 and matched controls without COVID-19. A 12-month landmark design excluded pre-existing deficiencies, skeletal outcomes, and early deaths. After 1:1 propensity score matching, Cox models estimated hazard ratios (HRs) for incident deficiencies and skeletal outcomes over an up-to-5-year analytic window, with tested-cohort, severity-gradient, competing-risk, and E-value analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, 645,168 patients remained per group. COVID-19 was associated with higher risks of vitamin D deficiency (HR, 1.79), magnesium deficiency (HR, 1.77), vitamin B12 deficiency (HR, 1.56), osteoporosis (HR, 1.55), osteoporotic fracture (HR, 1.73), femur fracture (HR, 1.58), and death (HR, 1.59; all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). Among patients with corresponding nutrient testing, risks remained higher for vitamin D deficiency (19.1% vs. 12.8%, HR, 1.68), magnesium deficiency (25.1% vs. 20.0%, HR, 1.47), and vitamin B12 deficiency (4.4% vs. 3.4%, HR, 1.42, all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). In tested cohorts, cumulative-incidence estimates remained higher after COVID-19 despite greater competing mortality. Risks were generally higher after severe infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with T2DM, COVID-19 was associated with increased long-term risks of laboratory-defined micronutrient deficiencies and skeletal outcomes. These hypothesis-generating findings warrant prospective confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1915257","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:29:32Z","timestamp":1788150572000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 and long-term risk of incident laboratory-defined micronutrient deficiency in patients with type 2 diabetes: a multicenter propensity score\u2013matched cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"I-Wen","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Hospital, Liouying","place":["Tainan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Chen","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, E-Da Hospital, I-Shou University","place":["Kaohsiung City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chuan","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chi Mei Medical Center","place":["Tainan City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1038\/s41591-024-02987-8","article-title":"Three-year outcomes of post-acute sequelae of COVID-19","volume":"30","author":"Cai","year":"2024","journal-title":"Nat Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1016\/S2213-8587(22)00355-2","article-title":"Risks and 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