tetano
Editor, Senior Moderator
Diabetologia
. 2021 Apr 28.
doi: 10.1007/s00125-021-05458-8. Online ahead of print.
Risk phenotypes of diabetes and association with COVID-19 severity and death: a living systematic review and meta-analysis
Sabrina Schlesinger[SUP] 1 2 [/SUP], Manuela Neuenschwander[SUP] 3 4 [/SUP], Alexander Lang[SUP] 3 [/SUP], Kalliopi Pafili[SUP] 4 5 [/SUP], Oliver Kuss[SUP] 3 4 6 [/SUP], Christian Herder[SUP] 4 5 7 [/SUP], Michael Roden[SUP] 4 5 7 [/SUP]
Affiliations
Abstract
Aims/hypothesis: Diabetes has been identified as a risk factor for poor prognosis of coronavirus disease-2019 (COVID-19). The aim of this study is to identify high-risk phenotypes of diabetes associated with COVID-19 severity and death.
Methods: This is the first edition of a living systematic review and meta-analysis on observational studies investigating phenotypes in individuals with diabetes and COVID-19-related death and severity. Four different databases were searched up to 10 October 2020. We used a random effects meta-analysis to calculate summary relative risks (SRR) with 95% CI. The certainty of evidence was evaluated by the GRADE tool.
Results: A total of 22 articles, including 17,687 individuals, met our inclusion criteria. For COVID-19-related death among individuals with diabetes and COVID-19, there was high to moderate certainty of evidence for associations (SRR [95% CI]) between male sex (1.28 [1.02, 1.61], n = 10 studies), older age (>65 years: 3.49 [1.82, 6.69], n = 6 studies), pre-existing comorbidities (cardiovascular disease: 1.56 [1.09, 2.24], n = 8 studies; chronic kidney disease: 1.93 [1.28, 2.90], n = 6 studies; chronic obstructive pulmonary disease: 1.40 [1.21, 1.62], n = 5 studies), diabetes treatment (insulin use: 1.75 [1.01, 3.03], n = 5 studies; metformin use: 0.50 [0.28, 0.90], n = 4 studies) and blood glucose at admission (?11 mmol/l: 8.60 [2.25, 32.83], n = 2 studies). Similar, but generally weaker and less precise associations were observed between risk phenotypes of diabetes and severity of COVID-19.
Conclusions/interpretation: Individuals with a more severe course of diabetes have a poorer prognosis of COVID-19 compared with individuals with a milder course of disease. To further strengthen the evidence, more studies on this topic that account for potential confounders are warranted.
. 2021 Apr 28.
doi: 10.1007/s00125-021-05458-8. Online ahead of print.
Risk phenotypes of diabetes and association with COVID-19 severity and death: a living systematic review and meta-analysis
Sabrina Schlesinger[SUP] 1 2 [/SUP], Manuela Neuenschwander[SUP] 3 4 [/SUP], Alexander Lang[SUP] 3 [/SUP], Kalliopi Pafili[SUP] 4 5 [/SUP], Oliver Kuss[SUP] 3 4 6 [/SUP], Christian Herder[SUP] 4 5 7 [/SUP], Michael Roden[SUP] 4 5 7 [/SUP]
Affiliations
- PMID: 33907860
- DOI: 10.1007/s00125-021-05458-8
Abstract
Aims/hypothesis: Diabetes has been identified as a risk factor for poor prognosis of coronavirus disease-2019 (COVID-19). The aim of this study is to identify high-risk phenotypes of diabetes associated with COVID-19 severity and death.
Methods: This is the first edition of a living systematic review and meta-analysis on observational studies investigating phenotypes in individuals with diabetes and COVID-19-related death and severity. Four different databases were searched up to 10 October 2020. We used a random effects meta-analysis to calculate summary relative risks (SRR) with 95% CI. The certainty of evidence was evaluated by the GRADE tool.
Results: A total of 22 articles, including 17,687 individuals, met our inclusion criteria. For COVID-19-related death among individuals with diabetes and COVID-19, there was high to moderate certainty of evidence for associations (SRR [95% CI]) between male sex (1.28 [1.02, 1.61], n = 10 studies), older age (>65 years: 3.49 [1.82, 6.69], n = 6 studies), pre-existing comorbidities (cardiovascular disease: 1.56 [1.09, 2.24], n = 8 studies; chronic kidney disease: 1.93 [1.28, 2.90], n = 6 studies; chronic obstructive pulmonary disease: 1.40 [1.21, 1.62], n = 5 studies), diabetes treatment (insulin use: 1.75 [1.01, 3.03], n = 5 studies; metformin use: 0.50 [0.28, 0.90], n = 4 studies) and blood glucose at admission (?11 mmol/l: 8.60 [2.25, 32.83], n = 2 studies). Similar, but generally weaker and less precise associations were observed between risk phenotypes of diabetes and severity of COVID-19.
Conclusions/interpretation: Individuals with a more severe course of diabetes have a poorer prognosis of COVID-19 compared with individuals with a milder course of disease. To further strengthen the evidence, more studies on this topic that account for potential confounders are warranted.