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Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression
Open accessAbstract
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; I2: 62%) and its subgroup which comprised of mortality (RR 2.12 [1.44, 3.11], p < 0.001; I2: 72%), severe COVID-19 (RR 2.45 [1.79, 3.35], p < 0.001; I2: 45%), ARDS (RR 4.64 [1.86, 11.58], p = 0.001; I2: 9%), and disease progression (RR 3.31 [1.08, 10.14], p = 0.04; I2: 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.
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30183-5 · Cited by 48,884
Clinical characteristics of coronavirus disease 2019 in China
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La certeza de lo impredecible: Cultura Educación y Sociedad en tiempos de COVID19
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Cited by
Holman, N., Knighton, P., Kar, P., O'Keefe, J., Curley, M., Weaver, A., Barron, E., Bakhai, C., Khunti, K., Wareham, N. J., et al. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30271-0 · Cited by 908
Beyerstedt, S., Casaro, E. B., & Rangel, É. B. (2021) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-020-04138-6 · Cited by 897
Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis
Huang, I., & Pranata, R. (2020) · Journal of Intensive Care · doi:10.1186/s40560-020-00453-4 · Cited by 662
Self-citationPredictors of mortality in hospitalized COVID‐19 patients: A systematic review and meta‐analysis
Tian, W., Jiang, W., Yao, J., Nicholson, C. J., Li, R. H., Sigurslid, H. H., Wooster, L., Rotter, J. I., Guo, X., & Malhotra, R. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26050 · Cited by 640
de Almeida-Pititto, B., Dualib, P. M., Zajdenverg, L., Dantas, J. R., de Souza, F. D., Rodacki, M., Bertoluci, M. C., & Brazilian Diabetes Society Study Group (SBD) (2020) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-020-00586-4 · Cited by 391
Metadata
- Authors
- Huang, I., Lim, M. A., & Pranata, R.
- Venue
- Diabetes & Metabolic Syndrome: Clinical Research & Reviews
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 14
- Issue
- 4
- Pages
- 395-403
- ISSN
- 1871-4021 (ISSN-L)
- OpenAlex
- W3016370968
- Cited by
- 933
- References
- 50
- FWCI
- 11.79
- Type
- journal article
- Language
- en
- Open access
- green
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- Huang, I., Lim, M. A., & Pranata, R. (2020). Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia – A systematic review, meta-analysis, and meta-regression. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. https://doi.org/10.1016/j.dsx.2020.04.018
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