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比较 1 型和 2 型糖尿病患者 COVID-19 结局的系统评价和荟萃分析。

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

机构信息

School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.

School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Diabetes Metab Syndr. 2022 Jun;16(6):102512. doi: 10.1016/j.dsx.2022.102512. Epub 2022 May 27.

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.

摘要

背景和目的

本系统评价和荟萃分析旨在评估目前可用于研究 1 型和 2 型糖尿病患者临床结局的证据。

方法

检索 MEDLINE(PubMed)、Scopus、Web of Science、Cochrane 图书馆、Google 学术和 Clinicaltrials.gov。纳入随机对照试验(RCT)、非随机试验和观察性研究。采用美国国立卫生研究院质量评估工具评估质量。采用受限极大似然随机效应方法进行数据合并。

结果

本研究共纳入 11 项研究,共计 7690415 例患者。所有原因死亡率的汇总数据的对数比值比(OR)为-0.71(95%置信区间:-1.38 至-0.03)。根据汇总结果,1 型糖尿病 COVID-19 患者的死亡率可能更好。两组之间在 ICU 入住率的对数 OR 无显著差异(0.22,95%置信区间:-0.81 至 0.37),住院率的对数 OR 无显著差异(-0.48,95%置信区间:-1.23 至 0.27)。根据我们调整年龄和合并症后的描述性分析,在三项研究中,高危组为 2 型糖尿病,在五项研究中,高危组为 1 型糖尿病。两项研究报告在这些组间的相关结局无显著差异。

结论

1 型和 2 型糖尿病的疾病严重程度无显著差异。根据现有的未调整数据,1 型糖尿病患者的死亡率低于 2 型糖尿病患者。由于这些研究对象的数据稀缺,且研究结果存在异质性,需要进一步进行具有足够样本量的研究,以准确比较 1 型和 2 型糖尿病 COVID-19 患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ee5/9135641/efef37873a36/gr1_lrg.jpg

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