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Published on: July 5, 2022
A Systematic Review and Meta-analysis of Diabetes Associated Mortality in Patients with COVID-19
Puneeta Gupta1, Meeta Gupta2, Neena KAtoch3
1Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital Jammu, Jammu, India.
Insights
Patients with diabetes mellitus face a significantly higher risk of mortality from Coronavirus disease 2019 (COVID-19). This systematic review highlights the increased odds of death for diabetic individuals, emphasizing the need for close monitoring.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) has emerged as a major global health crisis.
- Comorbid populations, particularly those with diabetes mellitus, exhibit increased mortality rates.
- Understanding the specific impact of diabetes on COVID-19 outcomes is crucial for public health strategies.
Purpose of the Study:
- To conduct a systematic review and meta-analysis on COVID-19 mortality.
- To determine the specific mortality rate associated with diabetes in COVID-19 patients.
- To quantify the increased risk of death for diabetic individuals with COVID-19.
Main Methods:
- A comprehensive literature search was performed across six major scientific databases.
- Full-text articles detailing COVID-19 and diabetes-associated mortality were screened and retrieved.
- Statistical analysis, including random-effects modeling and calculation of pooled odds ratios, was employed to synthesize data from 35 studies involving 25,934 patients.
Main Results:
- The pooled prevalence of diabetes mellitus among COVID-19 patients was 16.8%.
- Overall mortality in the included studies was 12.81%, while diabetes-associated mortality reached 22.14%.
- Diabetes mellitus was significantly associated with a higher mortality rate (22.14% vs. 12.81%, P < 0.05) and increased odds of death (pooled OR 1.83, 95% CI: 1.61 - 2.05).
Conclusions:
- Diabetes is a significant risk factor for increased mortality in hospitalized COVID-19 patients.
- Diabetic COVID-19 patients require continuous monitoring for glycemic control, coagulation, and inflammation.
- These findings underscore the importance of targeted interventions for diabetic individuals during the COVID-19 pandemic.
Context:
Coronavirus disease 2019 (COVID-19) has been one of the deadliest pandemics in recent decade. The virus has specifically targeted the comorbid population in terms of mortality. The present systematic review and meta-analysis aimed to determine the overall mortality and diabetes-associated mortality in COVID-19 patients.
Methods:
To obtain the related data, six databases, including Pubmed, Embase, MEDLINE, Web of Science, Google Scholar, and DOAJ, were searched. The full-texts of articles presenting the data of COVID-19 mortality and diabetes-associated mortality were screened and retrieved. Statistical analysis was performed using the Stata (version 13). The odds ratio (OR) of mortality in diabetic patients was calculated with 95% confidence interval (CI). Random-effects model was used to synthesize data for the relevant outcomes. Heterogeneity was evaluated using I2 statistic. Forest plots visually showed the effect estimates of the included studies. We used funnel plots to evaluate potential publication bias. A two tailed P < 0.05 was considered as statistically significant.
Results:
A total of 35 studies with 25,934 patients were finally included for meta-analysis. The pooled prevalence of diabetes mellitus in patients with COVID-19 was 16.8% (n = 4381). The overall mortality seen in all the studies was 12.81% (n = 3159), and diabetes-associated mortality was 22.14% (n = 970). The pooled analysis of included studies showed that diabetes mellitus had a significantly higher mortality rate (22.14% vs. 12.81%, P < 0.05) with higher odds of death (pooled OR 1.83, 95% CI: 1.61 - 2.05). The funnel plot was symmetric, thereby indicating a low risk of publication bias.
Conclusions:
In conclusion, the presence of diabetes was associated with a significantly increased risk of mortality in patients admitted to the hospital with COVID-19. Thus, this subpopulation must be continuously monitored for glycemic levels, coagulation abnormalities, and inflammatory surge.
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