Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis.
Medicine (Baltimore)
; 99(40): e22439, 2020 Oct 02.
Artículo
en Inglés
| MEDLINE | ID: covidwho-975378
ABSTRACT
BACKGROUND:
The mortality rate associated with Covid-19 varies considerably among studies and determinants of this variability are not well characterized.METHODS:
A systematic review of peer-reviewed literature published through March 31, 2020 was performed to estimate the mortality rate among hospitalized patients in China with a confirmed diagnosis of Covid-19. Hospital mortality rates were estimated using an inverse variance-weighted random-effects meta-analysis model. Funnel plot symmetry was evaluated for small-study effects, a one-study removed sensitivity analysis assessed the influence of individual studies on the pooled mortality rate, and metaregression assessed the association of potential confounding variables with mortality rates.RESULTS:
The review included 16 observational studies involving 1832 hospitalized patients with a diagnosis of Covid-19. The surveillance period among studies ranged from December 16, 2019 to February 23, 2020. The median patient age was 53 years and 53% were males. A total of 38.5% of patients presented with at least 1 comorbidity, most commonly hypertension (24.0%), cardiac disease (15.1%), and diabetes mellitus (14.4%). Fever and cough, reported in 84.8% and 61.7% of patients respectively, were the most common patient symptoms. The pooled mortality rate was 9.9% (95% confidence interval 6.1% to 14.5%). Funnel plot asymmetry was not observed and the meta-analysis results were not substantially influenced by any single study since the pooled mortality rate ranged from 8.9% to 11.1% following iterative removal of one study at a time. Substantial heterogeneity in the mortality rate was identified among studies (Iâ=â87%; Pâ<â.001). In a metaregression that included demographics, patient risk factors, and presenting symptoms, only a higher prevalence of diabetes mellitus was associated with a higher mortality rate (Pâ=â.03).CONCLUSIONS:
In a meta-analysis of hospitalized patients in China with a diagnosis of Covid-19, the mortality rate was 9.9% and a higher diabetes mellitus prevalence was independently associated with a worse prognosis. The independent influence of diabetes mellitus with Covid-19 mortality should be viewed as hypothesis-generating and warrants further study.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Mortalidad Hospitalaria
/
Infecciones por Coronavirus
/
Complicaciones de la Diabetes
/
Diabetes Mellitus
/
Betacoronavirus
Tipo de estudio:
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
/
Revisiones
/
Revisión sistemática/Meta análisis
Tópicos:
Covid persistente
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
/
Middle aged
Idioma:
Inglés
Revista:
Medicine (Baltimore)
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
MD.0000000000022439
Similares
MEDLINE
...
LILACS
LIS