Association between Diabetic Control (HbA1C) and the Risk of Developing Neurological Post-Acute Sequelae of COVID-19 (PASC)
Muhammed Ors1, Anam Shaikh1, Mustafa Jaffry1, Kranthi Mandava1, Kazim Jaffry1, Ronak Trivedi1, Iqra Faiz1, Firas Gerges2, Michel Boufadel2, Nizar Souayah1
1New Jersey Medical School, 2New Jersey Institute of Technology
Objective:
To investigate HbA1c as an independent risk factor in neurological PASC.
Background:
Prior literature has reported that diabetes is a risk factor for PASC. 
Design/Methods:

COVID-19 inpatients from a tertiary care center were retrospectively studied for presence of neurological PASC symptoms, 4 weeks to up to 1 year after their first inpatient admission COVID-19. Patients who had an HbA1c measured were grouped: Group A, HbA1c below 5.7%; Group B, HbA1c between 5.7% and 6.4%; Group C, HbA1c between 6.5% and 9%; Group D, HbA1c above 9%. The incidence of neurological PASC symptoms was compared.

Results:

Of the 433 COVID-19 patients reviewed, 160 patients (37.0%) had an HbA1c level measured during hospital stay. Of these, 75 patients (46.9%) had an outpatient follow-up or were readmitted to the hospital. These 75 patients were divided by HbA1c level: Group A (30.7%), Group B (21.3%), Group C (30.7%), and Group D (20.0%) p>0.05. For Group A vs B vs C vs D, numbness (13.0% vs 6.25% vs 17.4% vs 13.3%) p>0.05, paresthesias (4.35% vs 0% vs 13.0% vs 20.0%) p>0.05, brain fog or cognitive impairment (8.70% vs 12.5% vs 8.70% vs 6.67%) p>0.05, weakness (30.4% vs 37.5% vs 13.0% vs 13.3%) p>0.05, fatigue (30.4% vs 31.3% vs 34.8% vs 26.7%) p>0.05, headaches (21.7% vs 25.0% vs 13.0% vs 20.0%) p>0.05, changes in smell of taste (13.0% or 18.8% vs 17.4% vs 13.3%) p>0.05, sleep issues or insomnia (4.35% vs 0% vs 13.0% vs 0%) p>0.05 and anxiety or depression (17.4% vs 18.8% vs 4.35% vs 26.7%) p>0.05.

Conclusions:

This preliminary analysis demonstrates that there was no significant difference in the incidence of neurological PASC symptoms between the four groups. Work is in progress to look at HbA1c at multiple time points, expand the study size, increase the follow up time and adjust for comorbid and concomitant neurological conditions.

10.1212/WNL.0000000000203367