Risk of type 2 diabetes mellitus after respiratory syncytial viral infection: A retrospective cohort study using US database.

OBJECTIVE Whether respiratory syncytial virus (RSV) infection contributes to the development of type 2 diabetes (T2DM) or serves as an early warning indicator of T2DM risk remains unclear.

METHODS The study utilized TriNetX US Collaborative Database between January 1, 2022, and March 31, 2024. Patients with a history of T2DM diagnosis, antidiabetic medication use, or HbA1c ≥ 6.5 were excluded. RSV infection was designated as the index event with propensity score matching. The risk of T2DM was assessed using Cox proportional hazards regression models. Sensitivity analyses were conducted for two periods: 2010-2015 and 2016-2019, and across different databases.

RESULTS A total of 3,052,016 patients, including 15,205 with RSV (mean age, 51.1 years; 59.9% female) and 3,036,811 without RSV (mean age, 46.9 years; 53.4% female). T2DM incidence was 5.69% in the RSV group vs 2.48% in controls, HR 2.684 [95% CI: 2.378-3.030], E-value 4.81. Risk was significantly increased from infection to 3 and 6 months (HR 3 months: 2.697 [95% CI: 2.332-3.119]; HR 6 months: 2.271 [95% CI: 1.911-2.699]). All sensitivity analyses consistently showed a positive trend.

CONCLUSIONS Our findings suggest an association between RSV infection and subsequent T2DM. Prospective studies and mechanistic investigations are warranted to validate these observations and elucidate the underlying pathways.