2019冠状病毒病患者的糖尿病患病率和死亡率：一项系统评价、荟萃分析和元回归分析
Diabetes prevalence and mortality in COVID-19 patients: a systematic review, meta-analysis, and meta-regression.
作者信息
Saha Sumanta, Al-Rifai Rami H, Saha Sujata
机构信息
R. G. Kar Medical College, Kolkata, 700004 West Bengal India.
Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
出版信息
J Diabetes Metab Disord. 2021 Mar 31;20(1):939-950. doi: 10.1007/s40200-021-00779-2. eCollection 2021 Jun.
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 ( and Chi-squared ( ) 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; , 96.8 %) was 82 % (1.82-time) higher than that in non-DM patients (11.0 %, 95 % CI: 5.0-16.0; , 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, , 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. : PROSPERO (registration no. CRD42020196589).
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-021-00779-2.
背景
2019年冠状病毒病（COVID-19）合并糖尿病（DM）的患者有较高的死亡风险。本荟萃分析对住院COVID-19患者中（1）糖尿病患者、（2）非糖尿病患者的死亡率以及（3）糖尿病的患病率进行了量化。
方法
从四个电子数据库（PubMed、Embase、Scopus和medRxiv）检索已发表的研究，并使用美国国立心肺血液研究所的工具进行严格评估。采用随机效应模型进行荟萃分析。通过I²和卡方（ ）检验统计量确定异质性度量。使用荟萃回归模型对异质性预测因素进行量化。
结果
在审查的475篇出版物中，22项研究（主要是病例系列研究（59.09%）），提供了45775例住院COVID-19患者的数据，被认为符合要求。住院COVID-19合并DM患者的加权死亡率（20.0%，95%置信区间[CI]：15.0 - 26.0； ，96.8%）比非DM患者（11.0%，95% CI：5.0 - 16.0； ，99.3%）高82%（1.82倍）。DM患者的死亡率在欧洲最高（28.0%；95% CI：14.0 - 44.0），其次是美国（20.0%，95% CI：11.0 - 32.0）和亚洲（17.0%，95% CI：8.0 - 28.0）。COVID-19的样本量和严重程度与死亡率患病率的变异性相关（p < 0.05）。住院COVID-19患者中DM的加权患病率为20%（95%置信区间[CI]：15 - 25， ，99.3%）。总体而言，研究质量一般。
结论
住院COVID-19患者中DM的患病率较高，这给他们带来了明显负担。与非DM患者相比，DM增加了住院COVID-19患者的死亡风险，尤其是在重症患者中。：国际前瞻性系统评价注册库（注册号CRD42020196589）。
补充信息
在线版本包含可在10.1007/s40200-021-00779-2获取的补充材料。
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