Diabetes in patients with COVID-19 is associated with a two-fold increase in mortality as well as severity of COVID-19

Objectives:
Many studies on COVID-19 have reported diabetes to be associated with severe disease and mortality, however, the data is conflicting. Therefore, this review article has been conducted.

Does diabetes increase risk of COVID-19 infection?

Study design:
This review article included 33 case-control studies with 16,003 patients (8,849 (55%) were reported from Mainland China, 7,030 (44%) from USA and 124 (1%) from France). The pooled mean age was 52.6 ± 17.4 years.

20 out of 33 (61%) studies were from single centres, while remaining 13 (39%) were multi-centre studies.
Most studies (30/33, 91%) were from mainland China and of the remaining 3 studies, two (6%) were from USA and one (3%) from France.
The median number of patients included in the studies was 214 (IQR: 139-368).

32 studies (97%) were judged as good quality (scores of ≥8) and remaining 1 study (3%) was judged as fair quality (scores 6-7).

Results and conclusions:   
The investigators found diabetes was significantly associated with a 90% increased mortality risk of COVID-19 [pooled odds ratio = 1.90, 95% CI = 1.37 to 2.64 p  0.01, I2 = 32%].

The investigators found diabetes was significantly associated with a 126% increased risk of severe (including risk of ARDS, ICU requirement and invasive ventilatory requirement) COVID-19 [pooled odds ratio = 2.26, 95% CI = 1.78 to 2.87, p  0.01].

The investigators found, after adjusting for heterogeneity and publication bias, the combined corrected pooled odds ratio of mortality or severity was 2.16 [95% CI = 1.74 to 2.68, p  0.01].

The investigators found the pooled prevalence of diabetes in patients with COVID-19 was 9.8% [95% CI = 8.7% to 10.9%, after adjusting for heterogeneity].

The investigators concluded diabetes in patients with COVID-19 is associated with a two-fold increase in mortality as well as severity of COVID-19, as compared to non-diabetics. Further studies on the pathogenic mechanisms and therapeutic implications need to be done.

Original title:
Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis by Kumar A, Arora A, […], Srivastavab A.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200339/

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