Published online Oct 15, 2020. doi: 10.4239/wjd.v11.i10.468
Peer-review started: April 19, 2020
First decision: May 20, 2020
Revised: May 25, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 15, 2020
Processing time: 177 Days and 18.5 Hours
Coronavirus disease 2019 (COVID-19) has spread around the world rapidly. The prevalence of diabetes varies across different studies. Previous studies showed that COVID-19 patients with diabetes were prone to having poor clinical outcomes. However, a systematical review of the prevalence of diabetes in COVID-19 patients and the impact of diabetes on clinical outcomes has not been done in China.
We hypothesized that the presence of diabetes is associated with a poor prognosis. To our knowledge, this is the first meta-analysis which focused on evaluating the prevalence of diabetes among patients with COVID-19 infection in China and its impact on clinical outcomes.
The aim of this study was to systematically evaluate the prevalence of diabetes among COVID-19 patients in China and its impact on clinical outcomes, including ICU admission, progression to severe cases, or death.
A systematic review and meta-analysis of observational studies were performed.
Twenty-three eligible articles including 49564 COVID-19 patients (1573 with and 47991 without diabetes) were included. The pooled prevalence of diabetes was 10% [95% confidence interval (CI): 7%-15%] in COVID-19 patients. In the subgroup analyses, the pooled prevalence of diabetes was higher in studies on patients with a median age > 50 years (13%; 95%CI: 11%-16%) than studies on patients with a median age ≤ 50 years (7%; 95%CI: 6%-8%), in severe patients (17%; 95%CI: 14%-20%) than in non-severe patients (6%; 95%CI: 5%-8%), and in dead patients (30%; 95%CI: 13%-46%) than in survivors (8%; 95%CI: 2%-15%, all P < 0.05). Compared with patients without diabetes, the risks of severe cases [risk ratio (RR) = 2.13, 95%CI: 1.76-2.56, I2 = 49%] and death (RR = 3.16, 95%CI: 2.64-3.78, I2 = 34%) were both higher in COVID-19 patients with diabetes. However, diabetes was not found to be significantly associated with admission to ICU (RR = 1.16, 95%CI: 0.15-9.11).
Nearly one in ten COVID-19 patients have diabetes in China. Diabetes is associated with a higher risk of severe illness and death. The present study suggested that targeted early intervention is needed in COVID-19 patients with diabetes.
A systematic review and meta-analysis of observational studies which summarizes the evidence on this topic is meaningful. More adequate and vigorous research should be conducted to prove the associations found in this study.