Prevalence and impact of diabetes in hospitalized COVID‐19 patients: A systematic review and meta‐analysis

Abstract

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.

Impact of diabetes on clinical and safety outcomes in acute ischemic stroke patients receiving reperfusion therapy: A meta-analysis

“…30,42 During the current coronavirus disease 2019 (CO-VID-19) pandemic, an increasing attention is being paid to the disproportionate burden on patients with pre-existing diabetes. [43][44][45] Furthermore, studies also indicate that patients with diabetes may be at an increased risk of COVID-19 infection. 44 This highlights the need for comprehensive and tailored management of patients with diabetes during the pandemic and beyond, 43 as well as in stroke patients with pre-existing diabetes who are at risk of poor outcomes after AIS.…”

“…[43][44][45] Furthermore, studies also indicate that patients with diabetes may be at an increased risk of COVID-19 infection. 44 This highlights the need for comprehensive and tailored management of patients with diabetes during the pandemic and beyond, 43 as well as in stroke patients with pre-existing diabetes who are at risk of poor outcomes after AIS. [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]…”

The association between immunosuppressants and outcomes of COVID-19

“…In addition, because the patients may have multiple comorbidities and more comorbidities would be associated with the worse outcome of patients with COVID-19, we wondered whether the number of comorbidities using Charlson comorbidity index were matched or not between these two groups. Finally, diabetes mellitus (DM) is a common underlying disease of hospital patients with COVID-19 and can be associated with severe COVID-19, increased ARDS rate, mortality, and need for mechanical ventilation [ 2 ]. Although the authors described the use of diabetes drug, they did not show the prevalence of DM among the study subjects.…”

Effect of diabetes on short-term mortality and incidence of first hospitalizations for cardiovascular events after recovery from SARS-CoV-2 infection

“…Coronavirus 19 disease 2019 (COVID-19), associated with SARS-CoV-2 virus pandemic, leads to a significant increase in the risk of death, mainly affecting elderly people with chronic diseases including diabetes [1] , [2] , [3] , [4] , [5] . Moreover, COVID-19 shares with diabetes an increased risk of thrombotic or thromboembolic events leading to acute cardiovascular events [6] , [7] , [8] , [9] , [10] .…”