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Meta-Analysis
. 2022 Jun;16(6):102512.
doi: 10.1016/j.dsx.2022.102512. Epub 2022 May 27.

Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis

Arman Shafiee  1 , Mohammad Mobin Teymouri Athar  2 , Mahmoud Nassar  3 , Niloofar Seighali  4 , Dlnya Aminzade  2 , Payam Fattahi  2 , Maryam Rahmannia  2 , Zahra Ahmadi  5
Affiliations
Meta-Analysis

Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis

Arman Shafiee et al. Diabetes Metab Syndr. 2022 Jun.

Abstract

Background and aims: This systematic review and meta-analysis aimed to evaluate the current evidence available to investigate clinical outcomes between patients with type 1 and type 2 diabetes.

Methods: MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched. Randomized controlled trials (RCTs), non-randomized trials, and observational studies were eligible for inclusion. National Institutes of Health Quality Assessment Tool was used to assess the quality. Data were pooled by the Restricted-maximum-likelihood random-effects approach.

Results: Total 11 studies comprising 7690415 individuals were included in this study. The log OR for the pooled data for all-cause mortality rate was -0.71 (95% CI: -1.38 to -0.03). Based on the pooled results, type 1 diabetic COVID-19 patients may have a better prognosis for mortality. There were no significant differences between groups in term of ICU-admission log OR -0.22 (95% CI: -0.81 to 0.37), and hospitalization log OR -0.48 (95% CI: -1.23 to 0.27). Based on our descriptives analyses after adjusting for age and comorbidities, the high-risk group in three studies was type 2 diabetes, and in five studies was type 1. Two studies reported no significant difference between these groups in relevant outcomes.

Conclusion: There were no significant differences in disease severity between type 1 and type 2 diabetes. Based on the unadjusted data available, the mortality rate for people with type 1 diabetes was shown to be lower than that for people with type 2. As data on these subjects is scarce, and the results obtained from studies are heterogeneous, further research with adequate sample sizes is needed to precisely compare the outcomes of COVID-19 between type 1 and type 2 diabetes.

Keywords: COVID-19; Diabetes; Meta-analysis; Outcomes; Type 1 diabetes mellitus; Type 2 diabetes melltitus.

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Conflict of interest statement

Declaration of competing interest No Conflict of interest.

Figures

Fig. 1)
Fig. 1)
Database search and selection based on the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) approach.
Fig. 2)
Fig. 2)
Forest plots showing the results of meta-analyses for comparing COVID-19 outcomes in patients with type 1 and type 2 Diabetes. A) The rate of mortality was significantly lower in patients with type 1 diabetes, B) No significant difference was observed in terms of ICU admission between type 1 and type 2 diabetes, C) No significant difference was observed in terms of hospitalization between type 1 and type 2 diabetes,.
Fig. 3)
Fig. 3)
Sub-group meta-analysis based on adjusted/unadjusted data available for age, sex, and comorbidities. Most of the included studies only reported OR/RR after adjustment, therefore, large amount of data in meta-analysis are unadjusted for possible confounders. A) Mortality, B) ICU admission, C) Hospitalization. Yes: adjusted data; No: unadjusted data.
Fig. 4)
Fig. 4)
Sensitivity analyses of outcomes based on leave-one-out method. A) Mortality, B) ICU admission, C) Hospitalization.
Fig. 5)
Fig. 5)
Funnel plot of outcomes for evaluation of publication bias. A) Mortality, B) ICU admission, C) Hospitalization.
See this image and copyright information in PMC

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