{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T14:24:57Z","timestamp":1788531897507,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: The clinical course and mortality risk of COVID-19 in patients with type 2 diabetes (T2D) remain elevated. Understanding its pathogenesis is essential for prognostic and therapeutic strategies. Viral infections can disrupt host glucose and lipid metabolism. This study evaluated changes in glycemic and lipid parameters following COVID-19 infection in T2D patients. Methods: A retrospective analysis was conducted on T2D patients who tested positive for COVID-19 between April 2020 and December 2021. Laboratory results before and after infection were compared to assess changes in glycemic and lipid markers. Results: The study included 969 patients with T2D; 56.7% were female, and the median age was 58 years (IQR: 49\u201367). Hypertension, asthma, and chronic kidney disease were present in 51.5%, 14.2%, and 7.2% of patients, respectively. Fasting blood glucose did not change significantly from before to after COVID-19 infection [7.9 mmol\/L (IQR: 6.2\u201310.6) vs. 7.8 mmol\/L (IQR: 6.2\u201310.2)], nor did HbA1c [7.6% (IQR: 6.7\u20139.1) vs. 7.6% (IQR: 6.5\u20139.2)]. In contrast, modest but statistically significant reductions were observed in triglycerides [1.47 mmol\/L (IQR: 1.13\u20132.00) vs. 1.44 mmol\/L (IQR: 1.08\u20131.94)], total cholesterol [4.3 mmol\/L (IQR: 3.67\u20135.03) vs. 4.1 mmol\/L (IQR: 3.55\u20134.93)], and LDL cholesterol [2.7 mmol\/L (IQR: 2.11\u20133.45) vs. 2.5 mmol\/L (IQR: 1.98\u20133.23)]. HDL cholesterol remained unchanged [1.0 mmol\/L (IQR: 0.90\u20131.21) vs. 1.0 mmol\/L (IQR: 0.89\u20131.22)]. Conclusions: COVID-19 infection was not associated with significant long-term changes in glycemic control among patients with T2D, as fasting blood glucose and HbA1c levels remained broadly stable after infection. In contrast, significant reductions were observed in total cholesterol, LDL cholesterol, and triglyceride levels, while HDL cholesterol remained unchanged. These findings indicate that changes following COVID-19 infection were more apparent in lipid parameters than in glycemic markers.<\/jats:p>","DOI":"10.3390\/pathogens15090934","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:50:44Z","timestamp":1788529844000},"page":"934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Glycemic Control and Lipid Profiles Following COVID-19 Infection in Adults with Type 2 Diabetes: A Retrospective Study in Saudi Arabia"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9476-8197","authenticated-orcid":false,"given":"Yazeed","family":"Alshuweishi","sequence":"first","affiliation":[{"name":"Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9754-3826","authenticated-orcid":false,"given":"Jehad A.","family":"Aldali","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8228-1392","authenticated-orcid":false,"given":"Hamood","family":"Alsudais","sequence":"additional","affiliation":[{"name":"Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-8068","authenticated-orcid":false,"given":"Abdulrahman","family":"Alshalani","sequence":"additional","affiliation":[{"name":"Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7025-6543","authenticated-orcid":false,"given":"Abdulaziz M.","family":"Almuqrin","sequence":"additional","affiliation":[{"name":"Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4540-1732","authenticated-orcid":false,"given":"Badi A.","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Riyadh 11481, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1152\/physiolgenomics.00089.2020","article-title":"The COVID-19 pandemic: A global health crisis","volume":"52","author":"Pollard","year":"2020","journal-title":"Physiol. Genom."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1177\/15353702211054452","article-title":"Relationship between hyperglycemia, waist circumference, and the course of COVID-19: Mortality risk assessment","volume":"247","author":"Khalangot","year":"2022","journal-title":"Exp. Biol. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20200212","DOI":"10.1590\/1678-4685-gmb-2020-0212","article-title":"Molecular mechanisms and pharmacological interventions in the replication cycle of human coronaviruses","volume":"44","author":"Simabuco","year":"2020","journal-title":"Genet. Mol. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e13733","DOI":"10.1111\/apha.13733","article-title":"ACE2 function in the pancreatic islet: Implications for relationship between SARS-CoV-2 and diabetes","volume":"233","author":"Memon","year":"2021","journal-title":"Acta Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1111\/brv.12178","article-title":"De novo lipogenesis in the liver in health and disease: More than just a shunting yard for glucose","volume":"91","author":"Sanders","year":"2016","journal-title":"Biol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jare.2016.11.003","article-title":"Current level of evidence on causal association between hepatitis C virus and type 2 diabetes: A review","volume":"8","author":"Gastaldi","year":"2017","journal-title":"J. Adv. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.ecl.2014.06.003","article-title":"Dyslipidemia and cardiovascular risk in human immunodeficiency virus infection","volume":"43","author":"Kelesidis","year":"2014","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.cmet.2021.01.016","article-title":"Diabetes, obesity, metabolism, and SARS-CoV-2 infection: The end of the beginning","volume":"33","author":"Drucker","year":"2021","journal-title":"Cell Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1111\/cmi.12340","article-title":"Lipid interactions during virus entry and infection","volume":"16","author":"Mazzon","year":"2014","journal-title":"Cell. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jiph.2020.05.026","article-title":"Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study","volume":"13","author":"Alsofayan","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"753","DOI":"10.3201\/eid2504.181595","article-title":"Middle East respiratory syndrome coronavirus infection dynamics and antibody responses among clinically diverse patients, Saudi Arabia","volume":"25","author":"Midgley","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.2337\/dc21-1318","article-title":"COVID-19, hyperglycemia, and new-onset diabetes","volume":"44","author":"Khunti","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.2337\/dc20-1380","article-title":"Hyperglycemia at hospital admission is associated with severity of the prognosis in patients hospitalized for COVID-19: The Pisa COVID-19 study","volume":"43","author":"Coppelli","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"100373","DOI":"10.1016\/j.obmed.2021.100373","article-title":"Prognostic significance of temporal changes of lipid profile in COVID-19 patients","volume":"28","author":"Barman","year":"2021","journal-title":"Obes. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"307","DOI":"10.4103\/ijcm.IJCM_321_18","article-title":"Factors contributing to alcohol relapse in a rural population: Lessons from a camp-based de-addiction model from rural Karnataka","volume":"44","author":"Rampure","year":"2019","journal-title":"Indian J. Community Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1751-0473-3-17","article-title":"Purposeful selection of variables in logistic regression","volume":"3","author":"Bursac","year":"2008","journal-title":"Source Code Biol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1038\/s41579-020-00459-7","article-title":"Characteristics of SARS-CoV-2 and COVID-19","volume":"19","author":"Hu","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Khamidullina, Z., Avzaletdinova, D., Gareeva, D., Morugova, T., Lakman, I., Kopp, K., Fiedler, L., Motloch, L.J., and Zagidullin, N. (2024). Long-term outcomes of COVID-19 in hospitalized type 2 diabetes mellitus patients. Biomedicines, 12.","DOI":"10.3390\/biomedicines12020467"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Abu-Farha, M., Thanaraj, T.A., Qaddoumi, M.G., Hashem, A., Abubaker, J., and Al-Mulla, F. (2020). The role of lipid metabolism in COVID-19 virus infection and as a drug target. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21103544"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"9110","DOI":"10.1038\/s41598-017-09536-z","article-title":"Altered lipid metabolism in recovered SARS patients twelve years after infection","volume":"7","author":"Wu","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.atherosclerosis.2010.06.006","article-title":"Acute infection with Epstein\u2013Barr virus is associated with atherogenic lipid changes","volume":"212","author":"Apostolou","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.7754\/Clin.Lab.2019.190525","article-title":"Serum lipid metabolic derangement is associated with disease progression during chronic HBV infection","volume":"65","author":"Cao","year":"2019","journal-title":"Clin. Lab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1086\/649560","article-title":"High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection","volume":"201","author":"Baker","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1002\/oby.21764","article-title":"The association between cytomegalovirus infection, obesity, and metabolic syndrome in US adult females","volume":"25","author":"McClellan","year":"2017","journal-title":"Obesity"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2056","DOI":"10.1002\/rmv.2056","article-title":"Serum lipid profile as a predictor of dengue severity: A systematic review and meta-analysis","volume":"29","author":"Lima","year":"2019","journal-title":"Rev. Med. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.2337\/dc22-0730","article-title":"Effect of SARS-CoV-2 infection and infection severity on longer-term glycemic control and weight in people with type 2 diabetes","volume":"45","author":"Wong","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e1009","DOI":"10.1210\/clinem\/dgab792","article-title":"No evidence of long-term disruption of glycometabolic control after SARS-CoV-2 infection","volume":"107","author":"Laurenzi","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/s41574-021-00526-w","article-title":"How COVID-19 disrupts glycometabolic control","volume":"17","author":"Starling","year":"2021","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1111\/jdi.14021","article-title":"Impact of the COVID-19 pandemic on the glycemic control in people with diabetes mellitus: A retrospective cohort study","volume":"14","author":"Ohkuma","year":"2023","journal-title":"J. Diabetes Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103856","DOI":"10.1016\/j.amsu.2022.103856","article-title":"Effect of COVID-19 on lipid profile parameters and its correlation with acute phase reactants: A single-center retrospective analysis","volume":"78","author":"Almas","year":"2022","journal-title":"Ann. Med. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Li, G., Du, L., Cao, X., Wei, X., Jiang, Y., Lin, Y., Nguyen, V., Tan, W., and Wang, H. (2021). Follow-up study on serum cholesterol profiles and potential sequelae in recovered COVID-19 patients. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-05984-1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S2213-8587(22)00355-2","article-title":"Risks and burdens of incident dyslipidaemia in long COVID: A cohort study","volume":"11","author":"Xu","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Hern\u00e1ndez, Y., Oropeza-Valdez, J.J., Garc\u00eda Lopez, D.A., Borrego, J.C., Murgu, M., Valdez, J., L\u00f3pez, J.A., and Mon\u00e1rrez-Espino, J. (2023). Untargeted analysis in post-COVID-19 patients reveals dysregulated lipid pathways two years after recovery. Front. Mol. Biosci., 10.","DOI":"10.3389\/fmolb.2023.1100486"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lombrea, A., Romanescu, M., Jianu, N., Andor, M., Suciu, M., Man, D.E., Danciu, C., Dehelean, C.A., and Buda, V. (2023). Sex-Related Differences in the Pharmacological Response in SARS-CoV-2 Infection, Dyslipidemia, and Diabetes Mellitus: A Narrative Review. Pharmaceuticals, 16.","DOI":"10.3390\/ph16060853"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ejim.2008.06.011","article-title":"Gender differences in the lipid profile of dyslipidemic subjects","volume":"20","author":"Kolovou","year":"2009","journal-title":"Eur. J. Intern. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1210\/clinem\/dgae734","article-title":"Effectiveness of dexamethasone for COVID-19 in hospitalized patients with diabetes: A retrospective cohort study","volume":"110","author":"Bhat","year":"2025","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/9\/934\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T13:53:55Z","timestamp":1788530035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/9\/934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["pathogens15090934"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15090934","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}