Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis

Shafiee, Arman; Athar, Mohammad Mobin Teymouri; Nassar, Mahmoud; Seighali, Niloofar; Aminzade, Dlnya; Fattahi, Payam; Rahmannia, Maryam; Ahmadi, Zahra

doi:10.1016/j.dsx.2022.102512

Cited by 11 publications

(15 citation statements)

References 34 publications

(71 reference statements)

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“…We conducted a meta‐analysis based on pooled data from 26 primary studies 4–29 . A higher risk of severe COVID‐19 and mortality is associated with comorbidities such as cardiometabolic disease and diabetes 30,31 . Several AGMs have been studied, including etformin, DPP‐4i, sulfonylureas, glinide, SGLT‐2i, and GLP‐1RA.…”

Section: Discussionmentioning

confidence: 99%

“… 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 A higher risk of severe COVID‐19 and mortality is associated with comorbidities such as cardiometabolic disease and diabetes. 30 , 31 Several AGMs have been studied, including etformin, DPP‐4i, sulfonylureas, glinide, SGLT‐2i, and GLP‐1RA. Statistically significant findings include the following: metformin and GLP‐1RA use were associated with statistically significant reductions in mortality risk, DPP‐4i use was associated with a statistically significant increase in the likelihood of hospitalization and admission to ICU, and SGLT‐2i use was associated with a statistically significant reduction in hospitalization risk.…”

Section: Discussionmentioning

confidence: 99%

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Noninsulin‐based antihyperglycemic medications in patients with diabetes and COVID‐19: A systematic review and meta‐analysis

Nassar

Abosheaishaa

Singh

et al. 2023

Journal of Diabetes

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Background: Patients with diabetes are more likely to suffer COVID-19 complications. Using noninsulin antihyperglycemic medications (AGMs) during COVID-19 infection has proved challenging. In this study, we evaluate different noninsulin AGMs in patients with COVID-19.Methods: We searched Medline, Embase, Web of Science, and Cochrane on 24 January 2022. We used the following keywords (COVID-19) AND (diabetes mellitus) AND (antihyperglycemic agent). The inclusion criteria were studies reporting one or more of the outcomes. We excluded non-English articles, case reports, and literature reviews. Study outcomes were mortality, hospitalization, and intensive care unit (ICU) admission. Results: The use of metformin rather than other glucose-lowering medications was associated with statistically significant lower mortality (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.47, 0.77, p < .001). Dipeptidyl peptidase-4 inhibitor (DPP-4i) use was associated with statistically significantly higher hospitalization risk (RR: 1.44, 95% CI: 1.23, 1.68, p < .001) and higher risk of ICU admissions and/or mechanical ventilation vs nonusers (RR: 1.24, 95% CI: 1.04, 1.48, p < .02). There was a statistically significant decrease in hospitalization for SGLT-2i users vs nonusers (RR: 0.89, 95% CI: 0.84-0.95, p < .001). Glucagon-like peptide-1 receptor agonist (GLP-1RA) use was associated with a statistically significant decrease in mortality

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Noninsulin‐based antihyperglycemic medications in patients with diabetes and COVID‐19: A systematic review and meta‐analysis

Nassar

Abosheaishaa

Singh

et al. 2023

Journal of Diabetes

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“…Numerous studies have shown that diabetes mellitus (DM) increases the risk of death from COVID-19 by five times [ 1 , 2 ]. It is generally accepted that the high lethality from COVID-19 against the background of DM is due to the main complications of this disease: micro- and macroangiopathies, as well as heart and kidney failure.…”

Section: Introductionmentioning

confidence: 99%

Association of HLA Class I Genotype with Mortality in Patients with Diabetes Mellitus and COVID-19

Shkurnikov

Averinskaya

Komarov

et al. 2022

Dokl Biochem Biophys

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Numerous studies showed that diabetes mellitus (DM) increases the risk of death from COVID-19 by five times. It is generally accepted that the high lethality of COVID-19 against the background of DM is due to the main complications of this disease: micro-and macroangiopathies, as well as heart and kidney failure. In addition, it was shown that acute respiratory viral infection increases the production of interferon gamma, increases muscle resistance to insulin, and modulates the activity of effector CD8+ T cells. The ability of CD8+ T cells to recognize SARS-CoV-2-infected cells depends not only on humoral factors but also on individual genetic characteristics, including the individual set of major histocompatibility complex class I (MHC-I) molecules. In this study, the relationship of the MHC-I genotype of patients with DM aged less than 60 years with the outcome of COVID-19 was studied using a sample of 222 patients. It was shown that lethal outcomes of COVID-19 in patients with DM are associated with the low affinity of the interaction of an individual set of MHC-I molecules with SARS-CoV-2 peptides.

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“…Severe COVID‐19 has been defined as infection requiring inpatient care for treatment and respiratory support 1 . The few reports on outcomes for children or adults with type 1 diabetes (T1D) are mixed in terms of severity of disease and mortality compared to people without diabetes 2–6 . For adults with type 1 diabetes (T1D), having a co‐existing medical diagnosis such as cardiovascular disease, hypertension, or renal disease increases the risk of suffering from severe COVID‐19 and adverse outcomes 4,5,7–11 .…”

Section: Introductionmentioning

confidence: 99%

“…1 The few reports on outcomes for children or adults with type 1 diabetes (T1D) are mixed in terms of severity of disease and mortality compared to people without diabetes. [2][3][4][5][6] For adults with type 1 diabetes (T1D), having a co-existing medical diagnosis such as cardiovascular disease, hypertension, or renal disease increases the risk of suffering from severe COVID-19 and adverse outcomes. 4,5,[7][8][9][10][11] However, few published studies examine the relationship between comorbidities and severity of COVID-19 infection in children with T1D.…”

mentioning

confidence: 99%

Comorbidities increase COVID ‐19 hospitalization in young people with type 1 diabetes

et al. 2022

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Objectives We evaluated COVID‐19 outcomes in children and young adults with type 1 diabetes (T1D) to determine if those with comorbidities are more likely to experience severe COVID‐19 compared to those without. Research Design and Methods This cross‐sectional study included questionnaire data on patients <25 years of age with established T1D and laboratory‐confirmed COVID‐19 from 52 sites across the US between April 2020 and October 2021. We examined patient factors and COVID‐19 outcomes between those with and without comorbidities. Multivariate logistic regression analysis examined the odds of hospitalization among groups, adjusting for age, HbA1c, race and ethnicity, insurance type and duration of diabetes. Results Six hundred fifty‐one individuals with T1D and COVID‐19 were analyzed with mean age 15.8 (SD 4.1) years. At least one comorbidity was present in 31%, and more than one in 10%. Obesity and asthma were the most frequently reported comorbidities, present in 19% and 17%, respectively. Hospitalization occurred in 17% of patients and 52% of hospitalized patients required ICU level care. Patients with at least one comorbidity were almost twice as likely to be hospitalized with COVID‐19 than patients with no comorbidities (Odds ratio 2.0, 95% CI: 1.3–3.1). This relationship persisted after adjusting for age, HbA1c, race and ethnicity (minority vs nonminority), insurance type (public vs. private), and duration of diabetes. Conclusions Our findings show that comorbidities increase the risk for hospitalization with COVID‐19 in children and young adults highlighting the need for tailored COVID‐19 prevention and treatment strategies in T1D.

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Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis

Cited by 11 publications

References 34 publications

Noninsulin‐based antihyperglycemic medications in patients with diabetes and COVID‐19: A systematic review and meta‐analysis

Noninsulin‐based antihyperglycemic medications in patients with diabetes and COVID‐19: A systematic review and meta‐analysis

Association of HLA Class I Genotype with Mortality in Patients with Diabetes Mellitus and COVID-19

Comorbidities increase COVID ‐19 hospitalization in young people with type 1 diabetes

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