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Review
. 2021 Mar 31;20(1):939-950.
doi: 10.1007/s40200-021-00779-2. eCollection 2021 Jun.

Diabetes prevalence and mortality in COVID-19 patients: a systematic review, meta-analysis, and meta-regression

Sumanta Saha  1 , Rami H Al-Rifai  2 , Sujata Saha  3
Affiliations
Review

Diabetes prevalence and mortality in COVID-19 patients: a systematic review, meta-analysis, and meta-regression

Sumanta Saha et al. J Diabetes Metab Disord. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM) are at high risk of fatal outcomes. This meta-analysis quantifies the prevalence of mortality among (1) diabetic and (2) non-diabetic, and (3) the prevalence of DM, in hospitalized COVID-19 patients.

Methods: Published studies were retrieved from four electronic databases (PubMed, Embase, Scopus, and medRxiv) and appraised critically utilizing the National Heart, Lung, and Blood Institute's tool. Meta-analyses were performed using the random-effects model. The measures of heterogeneity were ascertained by I- squared (I 2 ) and Chi-squared (Chi 2 ) tests statistics. Predictors of heterogeneity were quantified using meta-regression models.

Results: Of the reviewed 475 publications, 22 studies (chiefly case series (59.09 %)), sourcing data of 45,775 hospitalized COVID-19 patients, were deemed eligible. The weighted prevalence of mortality in hospitlized COVID-19 patients with DM (20.0 %, 95 % CI: 15.0-26.0; I 2 , 96.8 %) was 82 % (1.82-time) higher than that in non-DM patients (11.0 %, 95 % CI: 5.0-16.0; I 2 , 99.3 %). The prevalence of mortality among DM patients was highest in Europe (28.0 %; 95 % CI: 14.0-44.0) followed by the United States (20.0 %, 95 % CI: 11.0-32.0) and Asia (17.0 %, 95 % CI: 8.0-28.0). Sample size and severity of the COVID-19 were associated (p < 0.05) with variability in the prevalence of mortality. The weighted prevalence of DM among hospitalized COVID-19 patients was 20 % (95 % confidence interval [CI]: 15-25, I 2 , 99.3 %). Overall, the quality of the studies was fair.

Conclusions: Hospitalized COVID-19 patients were appreciably burdened with a high prevalence of DM. DM contributed to the increased risk of mortality among hospitalized COVID-19 patients compared to non-DM patients, particularly among critically ill patients. Registration: PROSPERO (registration no. CRD42020196589).

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-021-00779-2.

Keywords: Coronavirus infection; Diabetes mellitus; Diabetes mellitus, type 1; Diabetes mellitus, type 2.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Prisma flow diagram [20]
Fig. 2
Fig. 2
Forest plot depicting the overall and diabetes mellitus (DM) type-wise prevalence of mortality in hospitalized COVID-19 patients with DM. The diamond is centred on the summary of the prevalence estimate, and the width indicates the corresponding 95 % CI
See this image and copyright information in PMC

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