tetano
Editor, Senior Moderator
Diabetes Metab Syndr. 2020 Apr 17;14(4):395-403. doi: 10.1016/j.dsx.2020.04.018. [Epub ahead of print]
Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression.
Huang I[SUP]1[/SUP], Lim MA[SUP]2[/SUP], Pranata R[SUP]3[/SUP].
Author information
Abstract
BACKGROUND AND AIMS:
Diabetes Mellitus (DM) is chronic conditions with devastating multi-systemic complication and may be associated with severe form of Coronavirus Disease 2019 (COVID-19). We conducted a systematic review and meta-analysis in order to investigate the association between DM and poor outcome in patients with COVID-19 pneumonia.
METHODS:
Systematic literature search was performed from several electronic databases on subjects that assess DM and outcome in COVID-19 pneumonia. The outcome of interest was composite poor outcome, including mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care, and disease progression.
RESULTS:
There were a total of 6452 patients from 30 studies. Meta-analysis showed that DM was associated with composite poor outcome (RR 2.38 [1.88, 3.03], p < 0.001; I[SUP]2[/SUP]: 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p < 0.001; I[SUP]2[/SUP]: 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p < 0.001; I[SUP]2[/SUP]: 45%), ARDS (RR 4.64 [1.86, 11.58], p = 0.001; I[SUP]2[/SUP]: 9%), and disease progression (RR 3.31 [1.08, 10.14], p = 0.04; I[SUP]2[/SUP]: 0%). Meta-regression showed that the association with composite poor outcome was influenced by age (p = 0.003) and hypertension (p < 0.001). Subgroup analysis showed that the association was weaker in studies with median age ≥55 years-old (RR 1.92) compared to <55 years-old (RR 3.48), and in prevalence of hypertension ≥25% (RR 1.93) compared to <25% (RR 3.06). Subgroup analysis on median age <55 years-old and prevalence of hypertension <25% showed strong association (RR 3.33) CONCLUSION: DM was associated with mortality, severe COVID-19, ARDS, and disease progression in patients with COVID-19.
Copyright ? 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.
KEYWORDS:
COVID-19; Coronavirus; Diabetes mellitus; Mortality; SARS-CoV-2
PMID:32334395DOI:10.1016/j.dsx.2020.04.018
Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression.
Huang I[SUP]1[/SUP], Lim MA[SUP]2[/SUP], Pranata R[SUP]3[/SUP].
Author information
Abstract
BACKGROUND AND AIMS:
Diabetes Mellitus (DM) is chronic conditions with devastating multi-systemic complication and may be associated with severe form of Coronavirus Disease 2019 (COVID-19). We conducted a systematic review and meta-analysis in order to investigate the association between DM and poor outcome in patients with COVID-19 pneumonia.
METHODS:
Systematic literature search was performed from several electronic databases on subjects that assess DM and outcome in COVID-19 pneumonia. The outcome of interest was composite poor outcome, including mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care, and disease progression.
RESULTS:
There were a total of 6452 patients from 30 studies. Meta-analysis showed that DM was associated with composite poor outcome (RR 2.38 [1.88, 3.03], p < 0.001; I[SUP]2[/SUP]: 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p < 0.001; I[SUP]2[/SUP]: 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p < 0.001; I[SUP]2[/SUP]: 45%), ARDS (RR 4.64 [1.86, 11.58], p = 0.001; I[SUP]2[/SUP]: 9%), and disease progression (RR 3.31 [1.08, 10.14], p = 0.04; I[SUP]2[/SUP]: 0%). Meta-regression showed that the association with composite poor outcome was influenced by age (p = 0.003) and hypertension (p < 0.001). Subgroup analysis showed that the association was weaker in studies with median age ≥55 years-old (RR 1.92) compared to <55 years-old (RR 3.48), and in prevalence of hypertension ≥25% (RR 1.93) compared to <25% (RR 3.06). Subgroup analysis on median age <55 years-old and prevalence of hypertension <25% showed strong association (RR 3.33) CONCLUSION: DM was associated with mortality, severe COVID-19, ARDS, and disease progression in patients with COVID-19.
Copyright ? 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.
KEYWORDS:
COVID-19; Coronavirus; Diabetes mellitus; Mortality; SARS-CoV-2
PMID:32334395DOI:10.1016/j.dsx.2020.04.018