Global Health Neurology and Translational Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.
University of New South Wales (UNSW), South-Western Sydney Clinical School, Sydney, New South Wales, Australia.
J Diabetes. 2022 Feb;14(2):144-157. doi: 10.1111/1753-0407.13243. Epub 2021 Dec 23.
Diabetes is a cardiometabolic comorbidity that may predispose COVID-19 patients to worse clinical outcomes. This study sought to determine the prevalence of diabetes in hospitalized COVID-19 patients and investigate the association of diabetes severe COVID-19, rate of acute respiratory distress syndrome (ARDS), mortality, and need for mechanical ventilation by performing a systematic review and meta-analysis.
Individual studies were selected using a defined search strategy, including results up until July 2021 from PubMed, Embase, and Cochrane Central Register of Controlled Trials. A random-effects meta-analysis was performed to estimate the proportions and level of association of diabetes with clinical outcomes in hospitalized COVID-19 patients. Forest plots were generated to retrieve the odds ratios (OR), and the quality and risk assessment was performed for all studies included in the meta-analysis.
The total number of patients included in this study was 10 648, of whom 3112 had diabetes (29.23%). The overall pooled estimate of prevalence of diabetes in the meta-analysis cohort was 31% (95% CI, 0.25-0.38; z = 16.09, P < .0001). Diabetes significantly increased the odds of severe COVID-19 (OR 3.39; 95% CI, 2.14-5.37; P < .0001), ARDS (OR 2.55; 95% CI, 1.74-3.75; P = <.0001), in-hospital mortality (OR 2.44; 95% CI, 1.93-3.09; P < .0001), and mechanical ventilation (OR 3.03; 95% CI, 2.17-4.22; P < .0001).
Our meta-analysis demonstrates that diabetes is significantly associated with increased odds of severe COVID-19, increased ARDS rate, mortality, and need for mechanical ventilation in hospitalized patients. We also estimated an overall pooled prevalence of diabetes of 31% in hospitalized COVID-19 patients.
糖尿病是一种合并心血管代谢疾病，可能使 COVID-19 患者的临床结局恶化。本研究旨在通过系统评价和荟萃分析，确定住院 COVID-19 患者中糖尿病的患病率，并探讨糖尿病与 COVID-19 重症、急性呼吸窘迫综合征（ARDS）发生率、死亡率和机械通气需求的相关性。
采用明确的检索策略，从 PubMed、Embase 和 Cochrane 中央对照试验注册库中选择单项研究，检索时间截至 2021 年 7 月。采用随机效应荟萃分析估计糖尿病与住院 COVID-19 患者临床结局的相关性。生成森林图以检索比值比（OR），并对荟萃分析中包含的所有研究进行质量和风险评估。
本研究共纳入 10648 例患者，其中 3112 例患有糖尿病（29.23%）。荟萃分析队列中糖尿病的总体患病率为 31%（95% CI，0.25-0.38；z=16.09，P<.0001）。糖尿病显著增加 COVID-19 重症（OR 3.39；95% CI，2.14-5.37；P<.0001）、ARDS（OR 2.55；95% CI，1.74-3.75；P<.0001）、院内死亡率（OR 2.44；95% CI，1.93-3.09；P<.0001）和机械通气（OR 3.03；95% CI，2.17-4.22；P<.0001）的几率。
本荟萃分析表明，糖尿病与住院 COVID-19 患者 COVID-19 重症、ARDS 发生率增加、死亡率增加和机械通气需求增加显著相关。我们还估计住院 COVID-19 患者中糖尿病的总体患病率为 31%。
