Background: The purpose of this study was to test the hypothesis that COVID‐19 status increases the incidence of new hypertension (HTN) and chronic kidney disease (CKD) in patients with Type 2 diabetes (T2D). Methods: This retrospective study consisted of 46,448 patients with T2D from the Montefiore Health System in the Bronx (3/01/2020–7/01/2023), of which 13,801 had a positive COVID‐19 test on record. Contemporary controls included those hospitalized for other lower respiratory tract infections (LRTIs) ( n = 1638) and nonhospitalized patients without COVID‐19 or LRTI ( n = 31009). Outcomes were assessed at follow‐up (2 months to 3 years) relative to baseline. Adjusted hazards ratios (aHRs) with 95% confidence interval (CI) were computed. Results: The cumulative incidences of HTN (22.32% vs. 9.13%, p < 0.001) and CKD (6.20% vs. 2.03%, p 0.05). Nonhospitalized COVID‐19 patients had higher risk of developing HTN compared to non‐COVID patients during all follow‐up (aHR 1.99, 95% CI [1.54, 2.57], p < 0.001), but hospitalized COVID‐19 patients had similar risk of developing HTN relative to patients hospitalized for LRTI (aHR 1.26 [0.70, 2.27], p = 0.441). Nonhospitalized COVID‐19 patients had higher risk of developing CKD compared to non‐COVID patients during all follow‐up (aHR 2.09 [1.69, 2.76], p < 0.001), but hospitalized COVID‐19 patients had similar risk of developing CKD relative to patients hospitalized for LRTI (aHR 0.96 [0.79, 1.36], p = 0.131). Conclusions: T2D patients with COVID‐19 were at higher risk of developing new disorders compared with COVID‐19‐negative controls and were at similar risk compared with those hospitalized for other LRTIs.

Background/Objectives: To investigate the incidence of new-onset diabetic retinopathy (DR) in individuals with pre-existing type 2 diabetes (T2D) up to 3 years post SARS-CoV-2 infection. Methods: This retrospective study consisted of 5151 COVID-19 and 5151 propensity-matched non-COVID-19 patients with T2D in the Montefiore Health System between 1 March 2020 and 17 January 2023. The primary outcome was new-onset DR at least 2 months after the index date up to 17 January 2023. Matching for index date between groups was also used to ensure the same follow-up duration. Hazard ratios (HRs) were computed, adjusted for competing risks. Results: T2D patients with COVID-19 had a higher cumulative incidence of DR than T2D patients. The unadjusted HR for COVID-19 status for developing new DR was 2.44 [1.60, 3.73], p < 0.001. The adjusted HR was 1.70 [1.08, 2.70], p < 0.05, and the adjusted HR for prior insulin use was 3.28 [2.10, 5.12], p < 0.001. Sex, ethnicity, and major comorbidities had no significant association with outcome. Conclusions: T2D patients who contracted COVID-19 exhibited a significantly higher risk of developing DR within three years post infection compared to propensity-matched controls. The increased incidence was primarily driven by greater pre-existing insulin usage and SARS-CoV-2 infection in the COVID-19 positive cohort.

Background: The Martini and Melamed criteria for diagnosing multiple primary lung cancers (MPLCs) have remained in use for half a century despite substantial changes in lung cancer epidemiology, risk factors, imaging technologies, and treatment approaches. Correspondingly, the landscape of MPLC has likely changed, necessitating revisions to their diagnostic guidelines. Research Question: What are the clinicopathologic profiles of modern-day MPLC patients, and can these features be used to identify a subset of patients classified as MPLC that may warrant additional investigation as intrapulmonary metastasis (IPM)? Study Design and Methods: We conducted a retrospective cohort study using electronic medical record data from patients who underwent multiple lung cancer resections at Mount Sinai Hospital. Patient demographics, tumor characteristics, and surgical treatments were compared with those reported in the original Martini and Melamed series. We then proposed a reclassification framework incorporating a CT-based assessment of synchronous versus metachronous tumors and contemporary clinicopathologic features documented in imaging and pathology reports. Results: Ninety-one patients underwent successive lung cancer resections. Among first nodules treated with surgical resection, 46% exhibited pathologic features suggestive of metastasis within the lung, including visceral pleural invasion (18%), vascular invasion (24%), lymphatic invasion (36%), and/or lymph node positivity (3%). In contrast, among second nodules (second temporal surgery), 45% demonstrated ground-glass opacity (GGO) supportive of a diagnosis of MPLC. Using the original criteria, 83 patients (91%) were classified as having MPLC; this proportion decreased to 53 patients (58%) under the reclassification criteria. Regardless of the criteria applied, contemporary MPLCs were more likely to occur in older patients, women, those with adenocarcinoma histology, and treated with sublobar resections compared with MPLCs described in the Martini and Melamed era. Conclusions: MPLCs are increasingly recognized, and their clinical presentation has changed substantially over time. Modern imaging and pathologic assessment may be useful tools for diagnosing MPLCs, but this requires future validation. This has important implications for staging and treatment decision-making, as patients may be undertreated by not being offered multimodal treatments or over-treated with systemic therapy when surgery alone may be sufficient.