Influence factors of death risk among COVID-19 patients in Wuhan, China: a hospital-based case-cohort study

Fu, Lin; Fei, Jun; Xiang, Hui-Xian; Xiang, Ying; Li, Meng-Die; Liu, Fangfang; Liu, Ying; Zhao, Hui; Xu, De-Xiang

doi:10.21203/rs.3.rs-26775/v1

Cited by 13 publications

(1 citation statement)

References 13 publications

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“…Included articles had to: (a) show available data on the number of patients with diabetes; (b) show available data on the number of deaths of SARS‐CoV‐2‐infected patients with diabetes; (c) be published in English or Chinese; and (d) include at least 20 cases. In total, six studies satisfied all the criteria 26–31 . The quality of all the included studies was evaluated using the Newcastle‐Ottawa Scale (Table S1).…”

Section: Methodsmentioning

confidence: 99%

Influence of diabetes mellitus on the severity and fatality of SARS‐CoV‐2 (COVID‐19) infection

Zhang

Sun

et al. 2020

Diabetes Obesity Metabolism

126

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Aim To evaluate the influence of diabetes on the severity and fatality of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection. Materials and Methods The medical records of 66 hospitalized coronavirus disease 2019 (COVID‐19) patients were collected and classified into non‐severe (mild/moderate cases) and severe (severe/critical cases) groups. Logistic regression analysis was used to estimate the risk of severe COVID‐19 (severe/critical infection). In addition, a meta‐analysis including published studies reported the impact of diabetes on the severity and fatality of COVID‐19. The current study was conducted using fixed effects models. Results There were 22 diabetes and 44 non‐diabetes cases among the 66 hospitalized COVID‐19 patients. Seven patients with diabetes (31.82%) were diagnosed as severe COVID‐19 cases, which was significantly higher than that in the non‐diabetes group (4/44, 9.09%, P = .033). After adjustment for age and gender, diabetes was significantly associated with COVID‐19 severity (OR: 5.29, 95% CI: 1.07–26.02). A meta‐analysis further confirmed the positive association between diabetes and COVID‐19 severity (pooled OR = 2.58, 95% CI: 1.93–3.45). Moreover, the patients with diabetes infected with SARS‐CoV‐2 had a 2.95‐fold higher risk of fatality compared with those patients without diabetes (95% CI: 1.93–4.53). Conclusions Our findings provide new evidence that diabetes is associated with a higher risk of severity and fatality of COVID‐19. Therefore, intensive monitoring and antidiabetic therapy should be considered in patients with diabetes with SARS‐CoV‐2 infection.

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Section: Methodsmentioning

confidence: 99%

Influence of diabetes mellitus on the severity and fatality of SARS‐CoV‐2 (COVID‐19) infection

Zhang

Sun

et al. 2020

Diabetes Obesity Metabolism

126

View full text Add to dashboard Cite

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Impact of diabetes on COVID‐19 mortality and hospital outcomes from a global perspective: An umbrella systematic review and meta‐analysis

Kastora

Patel

Carter

et al. 2022

Endocrino Diabet & Metabol

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Introduction To date, COVID‐19 has claimed 4.9 million lives. Diabetes has been identified as an independent risk factor of serious outcomes in people with COVID‐19 infection. Whether that holds true across world regions uniformly has not been previously assessed. Methods This study offers the first umbrella systematic review and meta‐analysis to analyse the collective and geographically stratified mortality, ICU admission, ventilation requirement, illness severity and discharge rate amongst patients with diabetes. Five databases (EMBASE, MEDLINE, CAB Abstracts, PsychInfo and Web of Science) and 3 additional sources (SSRN's eLibrary, Research Square and MedRxiv) were searched from inception to 30 August 2021. Prospective and retrospective cohort studies, reporting the association between diabetes and one or more COVID‐19 hospitalization outcomes, were included. This meta‐analysis was registered on PROSPERO, CRD42021278579. Abbreviated MeSH terms used for search were as follows: (Diabetes) AND (2019 Novel Coronavirus Disease), adapted per database requirements. Exclusion criteria exclusion criteria were as follows: (1) none of the primary or secondary outcomes of meta‐analysis reported, (2) no confirmed COVID‐19 infection (laboratory or clinical) and (3) no unexposed population (solely patients with diabetes included). Quality of the included studies were assessed using the Newcastle‐Ottawa Scale (NOS) whilst quality of evidence by the GRADE framework. Studies that were clinically homogeneous were pooled. Summative data and heterogeneity were generated by the Cochrane platform RevMan (V. 5.4). Results Overall, 158 observational studies were included, with a total of 270,212 of participants, median age 59 [53–65 IQR] of who 56.5% were male. A total of 22 studies originated from EU, 90 from Far East, 16 from Middle East and 30 from America. Data were synthesized with mixed heterogeneity across outcomes. Pooled results highlighted those patients with diabetes were at a higher risk of COVID‐19‐related mortality, OR 1.87 [95%CI 1.61, 2.17]. ICU admissions increased across all studies for patients with diabetes, OR 1.59 [95%CI 1.15, 2.18], a result that was mainly skewed by Far East‐originating studies, OR 1.94 [95%CI 1.51, 2.49]. Ventilation requirements were also increased amongst patients with diabetes worldwide, OR 1.44 [95%CI 1.20, 1.73] as well as their presentation with severe or critical condition, OR 2.88 [95%CI 2.29, 3.63]. HbA1C levels under <70 mmol and metformin use constituted protective factors in view of COVID‐19 mortality, whilst the inverse was true for concurrent insulin use. Conclusions Whilst diabetes constitutes a poor prognosticator for various COVID‐19 infection outcomes, variability across world regions is significant and may skew overall trends.

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Cardiac biomarkers, cardiac injury, and comorbidities associated with severe illness and mortality in coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

Zhu

Wang

et al. 2021

Immunity Inflam & Disease

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Aims To explore the correlation between cardiac‐related comorbidities, cardiac biomarkers, acute myocardial injury, and severity level, outcomes in COVID‐19 patients. Method Pubmed, Web of Science, Embase, CNKI, VIP, Wanfang, Cochrane Library databases, medRxiv, and Sinomed were reviewed systemically. Various types of clinical research reporting cardiac‐related comorbidities, cardiac biomarkers including lactate dehydrogenase (LDH), troponin I (TnI), high sensitivity troponin I (hs‐TnI), creatine kinase (CK), creatine kinase–MB (CK‐MB), myoglobin (Myo), N‐terminal pro‐b‐type natriuretic peptide (NT‐proBNP) and acute cardiac injury grouped by severity of COVID‐19 were included. Outcome measures were events and total sample size for comorbidities, acute cardiac injury, and laboratory parameters of these biomarkers. The study was performed with Stata version 15.1. Results Seventy studies, with a total of 15,354 cases were identified. The results showed that COVID‐19's severity was related to cardiovascular disease. Similar odds ratios (ORs) were achieved in hypertension except for severe versus critical group (OR = 1.406; 95% CI, 0.942–2.097; p = .095). The relative risk (RR) of acute cardiac injury is 7.01 (95% CI, 5.64–8.71) in non‐survivor cases. When compared with the different severity of cardiac biomarkers, the pool OR of CK, CK‐MB, TnI, Myo and LDH were 2.683 (95% CI, 0.83–8.671; p = .106; I 2 = 0%), 2.263 (95% CI, 0.939–5.457; p = .069), 1.242 (95% CI, 0.628–2.457; p = .534), 1.756 (95% CI, 0.608–5.071; p = .298; I 2 = 42.3%), 1.387 (95% CI, 0.707–2.721; p = .341; I 2 = 0%) in the critical versus severe group, whose trends were not similar to other groups. The standard mean differences (SMD) of CK and TnI in the critical versus severe group were 0.09 (95% CI, −0.33 to 0.50; p = .685; I 2 = 65.2%), 0.478 (95% CI, −0.183 to 1.138; p = .156; I 2 = 76.7%), which means no difference was observed in the serum level of these indicators. Conclusion Most of the findings clearly indicate that hypertension, cardiovascular disease, acute cardiac injury, and related laboratory indicators are associated with the severity of COVID‐19. What is now needed are cross‐national prospectively designed observational or clinical trials that will help improve the certainty of the available evidence and treatment decisions for patients.

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Influence factors of death risk among COVID-19 patients in Wuhan, China: a hospital-based case-cohort study

Cited by 13 publications

References 13 publications

Influence of diabetes mellitus on the severity and fatality of SARS‐CoV‐2 (COVID‐19) infection

Influence of diabetes mellitus on the severity and fatality of SARS‐CoV‐2 (COVID‐19) infection

Impact of diabetes on COVID‐19 mortality and hospital outcomes from a global perspective: An umbrella systematic review and meta‐analysis

Cardiac biomarkers, cardiac injury, and comorbidities associated with severe illness and mortality in coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

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