Risk phenotypes of diabetes and association with COVID-19 severity and death: a living systematic review and meta-analysis.
Diabetologia
; 64(7): 1480-1491, 2021 07.
Article
in English
| MEDLINE | ID: covidwho-1204881
ABSTRACT
AIMS/HYPOTHESIS:
Diabetes has been identified as a risk factor for poor prognosis of coronavirus disease-2019 (COVID-19). The aim of this study is to identify high-risk phenotypes of diabetes associated with COVID-19 severity and death.METHODS:
This is the first edition of a living systematic review and meta-analysis on observational studies investigating phenotypes in individuals with diabetes and COVID-19-related death and severity. Four different databases were searched up to 10 October 2020. We used a random effects meta-analysis to calculate summary relative risks (SRR) with 95% CI. The certainty of evidence was evaluated by the GRADE tool.RESULTS:
A total of 22 articles, including 17,687 individuals, met our inclusion criteria. For COVID-19-related death among individuals with diabetes and COVID-19, there was high to moderate certainty of evidence for associations (SRR [95% CI]) between male sex (1.28 [1.02, 1.61], n = 10 studies), older age (>65 years 3.49 [1.82, 6.69], n = 6 studies), pre-existing comorbidities (cardiovascular disease 1.56 [1.09, 2.24], n = 8 studies; chronic kidney disease 1.93 [1.28, 2.90], n = 6 studies; chronic obstructive pulmonary disease 1.40 [1.21, 1.62], n = 5 studies), diabetes treatment (insulin use 1.75 [1.01, 3.03], n = 5 studies; metformin use 0.50 [0.28, 0.90], n = 4 studies) and blood glucose at admission (≥11 mmol/l 8.60 [2.25, 32.83], n = 2 studies). Similar, but generally weaker and less precise associations were observed between risk phenotypes of diabetes and severity of COVID-19. CONCLUSIONS/INTERPRETATION:
Individuals with a more severe course of diabetes have a poorer prognosis of COVID-19 compared with individuals with a milder course of disease. To further strengthen the evidence, more studies on this topic that account for potential confounders are warranted. REGISTRATION PROSPERO registration ID CRD42020193692.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Diabetes Mellitus
/
COVID-19
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Diabetologia
Year:
2021
Document Type:
Article
Affiliation country:
S00125-021-05458-8
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