Background: Diabetes is a cardiometabolic comorbidity that may predispose COVID-19 patients to worse clinical outcomes. This study sought to determine the prevalence of diabetes in hospitalized COVID-19 patients and investigate the association of diabetes severe COVID-19, rate of acute respiratory distress syndrome (ARDS), mortality, and need for mechanical ventilation by performing a systematic review and meta-analysis.
Methods: Individual studies were selected using a defined search strategy, including results up until July 2021 from PubMed, Embase, and Cochrane Central Register of Controlled Trials. A random-effects meta-analysis was performed to estimate the proportions and level of association of diabetes with clinical outcomes in hospitalized COVID-19 patients. Forest plots were generated to retrieve the odds ratios (OR), and the quality and risk assessment was performed for all studies included in the meta-analysis.
Results: The total number of patients included in this study was 10 648, of whom 3112 had diabetes (29.23%). The overall pooled estimate of prevalence of diabetes in the meta-analysis cohort was 31% (95% CI, 0.25-0.38; z = 16.09, P < .0001). Diabetes significantly increased the odds of severe COVID-19 (OR 3.39; 95% CI, 2.14-5.37; P < .0001), ARDS (OR 2.55; 95% CI, 1.74-3.75; P = <.0001), in-hospital mortality (OR 2.44; 95% CI, 1.93-3.09; P < .0001), and mechanical ventilation (OR 3.03; 95% CI, 2.17-4.22; P < .0001).
Conclusions: Our meta-analysis demonstrates that diabetes is significantly associated with increased odds of severe COVID-19, increased ARDS rate, mortality, and need for mechanical ventilation in hospitalized patients. We also estimated an overall pooled prevalence of diabetes of 31% in hospitalized COVID-19 patients.
背景: 糖尿病是心脏代谢性伴随疾病, 可能使新型冠状病毒肺炎患者的临床结局更差。本研究旨在通过系统回顾和meta分析, 确定住院新型冠状病毒肺炎患者中糖尿病的患病率, 并调查糖尿病与严重新型冠状病毒肺炎疾病, 急性呼吸窘迫综合征(ARDS)发生率, 死亡率和机械通气需求之间的关系。 方法: 从PubMed, Embase和Cochrane Central Register of Control Trials中选择个别研究, 采用定义的搜索策略, 包括截至2021年7月的结果。对住院的新型冠状病毒肺炎患者进行随机效应meta分析, 以评估糖尿病与临床结果的比例和水平。生成森林图以检索优势比, 并对meta分析中包括的所有研究进行质量和风险评估。 结果: 本研究共纳入患者10648例, 其中糖尿病患者3112例(29.23%)。Meta分析队列中糖尿病总体合并估计的患病率为31%(95% CI 0.25-0.38, z=16.09 p<0.0001)。糖尿病显著增加严重新型冠状病毒肺炎严重程度(OR 3.39, 95% CI 2.14~5.37, p<0.0001), 急性呼吸窘迫综合征(OR 2.55, 95% CI 1.74~3.75, p=<0.0001), 住院死亡率(OR 2.44, 95% CI 1.93~3.09, p<0.0001)和机械通气(OR 3.03, 95%CI 2.17~4.22, p<0.0001)。 结论: 我们的meta分析显示糖尿病与住院患者严重新型冠状病毒肺炎, 急性呼吸窘迫综合征的发生率, 死亡率和需要机械通气的增加显著相关。我们还估计在住院的新型冠状病毒肺炎患者中糖尿病的总体合并患病率为31%。.
Keywords: COVID-19; SARS-CoV-2; diabetes; meta-analysis; meta分析; mortality; prevalence; ventilation; 患病率; 新型冠状病毒肺炎; 死亡率; 糖尿病; 通气.
© 2021 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.