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. 2021 Sep 25;10(5):275-287.
doi: 10.5501/wjv.v10.i5.275.

New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis

Dhan Bahadur Shrestha  1 , Pravash Budhathoki  2 , Sumit Raut  3 , Sugat Adhikari  4 , Prinska Ghimire  5 , Sabin Thapaliya  6 , Ali A Rabaan  7 , Bibodh Jung Karki  8
Affiliations

New-onset diabetes in COVID-19 and clinical outcomes: A systematic review and meta-analysis

Dhan Bahadur Shrestha et al. World J Virol. .

Abstract

Background: Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with coronavirus disease 2019 (COVID-19). The relationship between diabetes and COVID-19 is known to be bidirectional.

Aim: To analyze the rate of new-onset diabetes in COVID-19 patients and compare the clinical outcomes of new-onset diabetes, pre-existing diabetes, hyperglycemic, and non-diabetes among COVID-19 patients.

Methods: We used the Meta-analysis of Observational Studies in Epidemiology statement for the present meta-analysis. Online databases were searched for all peer-reviewed articles published until November 6, 2020. Articles were screened using Covidence and data extracted. Further analysis was done using comprehensive meta-analysis. Among the 128 studies detected after thorough database searching, seven were included in the quantitative analysis. The proportion was reported with 95% confidence interval (CI) and heterogeneity was assessed using I 2.

Results: Analysis showed that 19.70% (CI: 10.93-32.91) of COVID-19 patients had associated DM, and 25.23% (CI: 19.07-32.58) had associated hyperglycemia. The overall mortality rate was 15.36% (CI: 12.57-18.68) of all COVID-19 cases, irrespective of their DM status. The mortality rate was 9.26% among non-diabetic patients, 10.59% among patients with COVID-19 associated hyperglycemia, 16.03% among known DM patients, and 24.96% among COVID-19 associated DM patients. The overall occurrence of adverse events was 20.52% (CI: 14.21-28.70) among COVID-19 patients in the included studies, 15.29% among non-diabetic patients, 20.41% among patients with COVID-19 associated hyperglycemia, 20.69% among known DM patients, and 45.85% among new-onset DM. Meta-regression showed an increasing rate of mortality among new hyperglycemic patients, known diabetics, and new-onset DM patients in comparison to those without diabetes.

Conclusion: A significantly higher rate of new onset DM and hyperglycemia was observed. Higher mortality rates and adverse events were seen in patients with new-onset DM and hyperglycemia than in the non-diabetic population.

Keywords: Acute respiratory distress syndrome; COVID-19; Diabetes mellitus; Hyperglycemia; Mortality.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Prevalence of coronavirus disease 2019 associated new onset diabetes mellitus. COVID-19: Coronavirus disease 2019; DM: Diabetes mellitus.
Figure 3
Figure 3
Prevalence of coronavirus disease 2019 associated hyperglycemia. COVID-19: Coronavirus disease 2019.
Figure 4
Figure 4
Mortality among coronavirus disease 2019 cases with subgroup analysis based on their diabetes status. COVID-19: Coronavirus disease 2019; DM: Diabetes mellitus.
Figure 5
Figure 5
Occurrence of adverse events among coronavirus disease 2019 cases with subgroup analysis based on their diabetes status. COVID-19: Coronavirus disease 2019; DM: Diabetes mellitus; ICU: Intensive care unit.
Figure 6
Figure 6
Meta regression of diabetes status and mortality.
See this image and copyright information in PMC

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