Purpose

Infectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. The aim of this study was to systematically review and conduct a meta-analysis of the available observational studies reporting the effect of diabetes on mortality among hospitalized patients with COVID-19.

Methods

The Medline, Embase, Google Scholar, and medRxiv databases were reviewed for identification of eligible studies. A random effects model meta-analysis was used, and I² was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed.

Results

A total of 18,506 patients were included in this meta-analysis (3713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared with patients without diabetes (OR 1.65; 95% CI 1.35–1.96; I² 77.4%). The heterogeneity was high. A study-level meta-regression analysis was performed for all the important covariates, and no significant interactions were found between the covariates and the outcome of mortality.

Conclusion

This meta-analysis shows that that the likelihood of death seems to be higher in diabetic patients hospitalized with COVID-19 compared with non-diabetic patients. Further studies are needed to assess whether this association is independent or not, as well as to investigate the role of adequate glycemic control prior to infection with COVID-19.

中文翻译：

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糖尿病与 COVID-19 患者住院死亡率增加有关：一项包含 18,506 名患者的系统评价和荟萃分析

目的

传染病更为常见，并且可能与糖尿病患者的不良预后有关。本研究的目的是对现有的观察性研究进行系统回顾和荟萃分析，这些研究报告了糖​​尿病对 COVID-19 住院患者死亡率的影响。

方法

审查了 Medline、Embase、Google Scholar 和 medRxiv 数据库，以确定符合条件的研究。使用随机效应模型荟萃分析，并使用I ²来评估异质性。住院死亡率被定义为终点。进行了敏感性、亚组和元回归分析。

结果

该荟萃分析共纳入 18,506 名患者（3713 名糖尿病患者和 14,793 名非糖尿病患者）。与非糖尿病患者相比，糖尿病患者的死亡风险更高（OR 1.65；95% CI 1.35–1.96；I ² 77.4%）。异质性很高。对所有重要的协变量进行了研究级别的元回归分析，未发现协变量与死亡率结果之间存在显着的交互作用。

结论

这项荟萃分析表明，与非糖尿病患者相比，因 COVID-19 住院的糖尿病患者的死亡可能性似乎更高。需要进一步的研究来评估这种关联是否独立，并研究在感染 COVID-19 之前充分控制血糖的作用。