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Meta-Analysis
. 2020 Oct;51(7):700-709.
doi: 10.1016/j.arcmed.2020.07.005. Epub 2020 Aug 7.

Diabetes Mellitus is Associated with Severe Infection and Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

Luxiang Shang  1 , Mengjiao Shao  2 , Qilong Guo  3 , Jia Shi  3 , Yang Zhao  4 , Jiasuoer Xiaokereti  3 , Baopeng Tang  5
Affiliations
Meta-Analysis

Diabetes Mellitus is Associated with Severe Infection and Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

Luxiang Shang et al. Arch Med Res. 2020 Oct.

Abstract

Background and aim: Currently, the number of patients with coronavirus disease 2019 (COVID-19) infection is increasing rapidly worldwide. In this study, we aimed to assess whether diabetes mellitus (DM) would increase the risk of severe infection and death in patients with COVID-19.

Methods: We systematically searched the PubMed, Web of Science, MedRxiv and COVID-19 academic research communication platform for studies reporting clinical severity and/or overall mortality data on DM in patients with COVID-19 published up to July 10, 2020. The primary outcome was to compare the severe infection rate and mortality rate in COVID-19 patients with and without DM, and to calculate the odds ratio (OR) and 95% confidence interval (CI).

Results: A total of 76 studies involving 31,067 patients with COVID-19 were included in our meta-analysis. COVID-19 patients with DM had higher severe infection and case-mortality rates compared with those without DM (21.4 vs. 10.6% and 28.5 vs. 13.3%, respectively, all p <0.01). COVID-19 patients with DM were at significantly elevated risk of severe infection (OR = 2.38, 95% CI: 2.05-2.78, p <0.001) and mortality (OR = 2.21, 95% CI: 1.83-2.66, p <0.001).

Conclusion: DM is associated with increased risk of severe infection and higher mortality in patients with COVID-19. Our study suggests that clinicians should pay more attention to the monitoring and treatment of COVID-19 patients with DM.

Keywords: COVID-19; Diabetes mellitus; Disease severity; Meta-analysis; Mortality.

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Figures

Figure 1
Figure 1
Flow diagram for literature selection.
Figure 2
Figure 2
Forest plot for the association of DM and disease severity in patients with COVID-19.
Figure 3
Figure 3
Forest plot for the association of DM and mortality in patients with COVID-19.
Figure 4
Figure 4
Funnel plot for the assessment of publication bias. (A) Outcome of severe infection; (B) Outcome of mortality.
Supplementary Figure
Supplementary Figure
See this image and copyright information in PMC

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