The raging COVID-19 pandemic is in its third year of global impact. The SARS CoV 2
virus has a high rate of spread, protean manifestations, and a high morbidity and
mortality in individuals with predisposing risk factors. The pathophysiologic mechanisms
involve a heightened systemic inflammatory state, cardiometabolic derangements, and
varying degrees of glucose intolerance. The latter can be evident as significant hyperglycemia
leading to new-onset diabetes or worsening of preexisting disease. Unfortunately,
the clinical course beyond the acute phase of the illness may persist in the form
of a variety of symptoms that together form the so-called “Long COVID” or “Post-COVID
Syndrome”. It is thought that a chronic, low-grade inflammatory and immunologic state
persists during this phase, which may last for weeks or months. Although numerous
insights have been gained into COVID-related hyperglycemia and diabetes, its prediction,
course, and management remain to be fully elucidated.
