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Meta-Analysis
. 2022 Dec:137:155330.
doi: 10.1016/j.metabol.2022.155330. Epub 2022 Oct 8.

Risk of incident diabetes after COVID-19 infection: A systematic review and meta-analysis

Honghao Lai  1 , Manli Yang  2 , Mingyao Sun  3 , Bei Pan  4 , Quan Wang  5 , Jing Wang  6 , Jinhui Tian  7 , Guowu Ding  1 , Kehu Yang  8 , Xuping Song  9 , Long Ge  10
Affiliations
Meta-Analysis

Risk of incident diabetes after COVID-19 infection: A systematic review and meta-analysis

Honghao Lai et al. Metabolism. 2022 Dec.

Abstract

Background: COVID-19 might be a risk factor for various chronic diseases. However, the association between COVID-19 and the risk of incident diabetes remains unclear. We aimed to meta-analyze evidence on the relative risk of incident diabetes in patients with COVID-19.

Methods: In this systematic review and meta-analysis, the Embase, PubMed, CENTRAL, and Web of Science databases were searched from December 2019 to June 8, 2022. We included cohort studies that provided data on the number, proportion, or relative risk of diabetes after confirming the COVID-19 diagnosis. Two reviewers independently screened studies for eligibility, extracted data, and assessed risk of bias. We used a random-effects meta-analysis to pool the relative risk with corresponding 95 % confidence intervals. Prespecified subgroup and meta-regression analyses were conducted to explore the potential influencing factors. We converted the relative risk to the absolute risk difference to present the evidence. This study was registered in advance (PROSPERO CRD42022337841).

Main findings: Ten articles involving 11 retrospective cohorts with a total of 47.1 million participants proved eligible. We found a 64 % greater risk (RR = 1.64, 95%CI: 1.51 to 1.79) of diabetes in patients with COVID-19 compared with non-COVID-19 controls, which could increase the number of diabetes events by 701 (558 more to 865 more) per 10,000 persons. We detected significant subgroup effects for type of diabetes and sex. Type 2 diabetes has a higher relative risk than type 1. Moreover, men may be at a higher risk of overall diabetes than women. Sensitivity analysis confirmed the robustness of the results. No evidence was found for publication bias.

Conclusions: COVID-19 is strongly associated with the risk of incident diabetes, including both type 1 and type 2 diabetes. We should be aware of the risk of developing diabetes after COVID-19 and prepare for the associated health problems, given the large and growing number of people infected with COVID-19. However, the body of evidence still needs to be strengthened.

Keywords: COVID-19; Diabetes; Long COVID; Public health.

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Conflict of interest statement

Declaration of competing interest All authors have no conflicts of interest relevant to this article to disclose.

Figures

Unlabelled Image
Graphical abstract
Fig. 1
Fig. 1
Literature screening flow diagram.
Fig. 2
Fig. 2
Relative risk of diabetes, type 1 diabetes, and type 2 diabetes in patients with COVID-19 compared with those without COVID-19.
See this image and copyright information in PMC

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