tetano
Editor, Senior Moderator
World J Virol
. 2021 Sep 25;10(5):275-287.
doi: 10.5501/wjv.v10.i5.275.
New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis
Dhan Bahadur Shrestha[SUP] 1 [/SUP], Pravash Budhathoki[SUP] 2 [/SUP], Sumit Raut[SUP] 3 [/SUP], Sugat Adhikari[SUP] 4 [/SUP], Prinska Ghimire[SUP] 5 [/SUP], Sabin Thapaliya[SUP] 6 [/SUP], Ali A Rabaan[SUP] 7 [/SUP], Bibodh Jung Karki[SUP] 8 [/SUP]
Affiliations
Abstract
Background: Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with coronavirus disease 2019 (COVID-19). The relationship between diabetes and COVID-19 is known to be bidirectional.
Aim: To analyze the rate of new-onset diabetes in COVID-19 patients and compare the clinical outcomes of new-onset diabetes, pre-existing diabetes, hyperglycemic, and non-diabetes among COVID-19 patients.
Methods: We used the Meta-analysis of Observational Studies in Epidemiology statement for the present meta-analysis. Online databases were searched for all peer-reviewed articles published until November 6, 2020. Articles were screened using Covidence and data extracted. Further analysis was done using comprehensive meta-analysis. Among the 128 studies detected after thorough database searching, seven were included in the quantitative analysis. The proportion was reported with 95% confidence interval (CI) and heterogeneity was assessed using I [SUP]2[/SUP].
Results: Analysis showed that 19.70% (CI: 10.93-32.91) of COVID-19 patients had associated DM, and 25.23% (CI: 19.07-32.58) had associated hyperglycemia. The overall mortality rate was 15.36% (CI: 12.57-18.68) of all COVID-19 cases, irrespective of their DM status. The mortality rate was 9.26% among non-diabetic patients, 10.59% among patients with COVID-19 associated hyperglycemia, 16.03% among known DM patients, and 24.96% among COVID-19 associated DM patients. The overall occurrence of adverse events was 20.52% (CI: 14.21-28.70) among COVID-19 patients in the included studies, 15.29% among non-diabetic patients, 20.41% among patients with COVID-19 associated hyperglycemia, 20.69% among known DM patients, and 45.85% among new-onset DM. Meta-regression showed an increasing rate of mortality among new hyperglycemic patients, known diabetics, and new-onset DM patients in comparison to those without diabetes.
Conclusion: A significantly higher rate of new onset DM and hyperglycemia was observed. Higher mortality rates and adverse events were seen in patients with new-onset DM and hyperglycemia than in the non-diabetic population.
Keywords: Acute respiratory distress syndrome; COVID-19; Diabetes mellitus; Hyperglycemia; Mortality.
. 2021 Sep 25;10(5):275-287.
doi: 10.5501/wjv.v10.i5.275.
New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis
Dhan Bahadur Shrestha[SUP] 1 [/SUP], Pravash Budhathoki[SUP] 2 [/SUP], Sumit Raut[SUP] 3 [/SUP], Sugat Adhikari[SUP] 4 [/SUP], Prinska Ghimire[SUP] 5 [/SUP], Sabin Thapaliya[SUP] 6 [/SUP], Ali A Rabaan[SUP] 7 [/SUP], Bibodh Jung Karki[SUP] 8 [/SUP]
Affiliations
- PMID: 34631477
- PMCID: PMC8474977
- DOI: 10.5501/wjv.v10.i5.275
Abstract
Background: Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with coronavirus disease 2019 (COVID-19). The relationship between diabetes and COVID-19 is known to be bidirectional.
Aim: To analyze the rate of new-onset diabetes in COVID-19 patients and compare the clinical outcomes of new-onset diabetes, pre-existing diabetes, hyperglycemic, and non-diabetes among COVID-19 patients.
Methods: We used the Meta-analysis of Observational Studies in Epidemiology statement for the present meta-analysis. Online databases were searched for all peer-reviewed articles published until November 6, 2020. Articles were screened using Covidence and data extracted. Further analysis was done using comprehensive meta-analysis. Among the 128 studies detected after thorough database searching, seven were included in the quantitative analysis. The proportion was reported with 95% confidence interval (CI) and heterogeneity was assessed using I [SUP]2[/SUP].
Results: Analysis showed that 19.70% (CI: 10.93-32.91) of COVID-19 patients had associated DM, and 25.23% (CI: 19.07-32.58) had associated hyperglycemia. The overall mortality rate was 15.36% (CI: 12.57-18.68) of all COVID-19 cases, irrespective of their DM status. The mortality rate was 9.26% among non-diabetic patients, 10.59% among patients with COVID-19 associated hyperglycemia, 16.03% among known DM patients, and 24.96% among COVID-19 associated DM patients. The overall occurrence of adverse events was 20.52% (CI: 14.21-28.70) among COVID-19 patients in the included studies, 15.29% among non-diabetic patients, 20.41% among patients with COVID-19 associated hyperglycemia, 20.69% among known DM patients, and 45.85% among new-onset DM. Meta-regression showed an increasing rate of mortality among new hyperglycemic patients, known diabetics, and new-onset DM patients in comparison to those without diabetes.
Conclusion: A significantly higher rate of new onset DM and hyperglycemia was observed. Higher mortality rates and adverse events were seen in patients with new-onset DM and hyperglycemia than in the non-diabetic population.
Keywords: Acute respiratory distress syndrome; COVID-19; Diabetes mellitus; Hyperglycemia; Mortality.