Viral infections may increase the risk of developing type 1 diabetes (T1D), and recent reports suggest that Coronavirus Disease 2019 (COVID‐19) might have increased the incidence of pediatric T1D and/or diabetic ketoacidosis (DKA). Therefore, this meta‐analysis aims to estimate the risk of global pediatric new‐onset T1D, DKA, and severe DKA before and after the COVID‐19 pandemic. A systematic search of MEDLINE/PubMed, CINAHL, Scopus, and EMBASE was conducted for articles published up to March 2022. A random‐effects meta‐analysis was performed to compare the relative risk of T1D and DKA among pediatric patients with T1D between the COVID‐19 pre‐pandemic and pandemic periods. We also compared glucose and HbA1c values in children who were newly diagnosed with T1D before and after the COVID‐19 pandemic. The global incidence rate of T1D in the 2019 period was 19.73 per 100 000 children and 32.39 per 100 000 in the 2020 period. Compared with pre‐COVID‐19 pandemic, the number of worldwide pediatric new‐onset T1D, DKA, and severe DKA during the first year of the COVID‐19 pandemic increased by 9.5%, 25%, and 19.5%, respectively. Compared with pre‐COVID‐19 pandemic levels, the median glucose, and HbA1c values in newly diagnosed T1D children after the COVID‐19 pandemic increased by 6.43% and 6.42%, respectively. The COVID‐19 pandemic has significantly increased the risk of global pediatric new‐onset T1D, DKA, and severe DKA. Moreover, higher glucose and HbA1c values in newly diagnosed T1D children after the COVID‐19 pandemic mandates targeted measures to raise public and physician awareness.

Among coronavirus disease 2019 (COVID‐19) patients, physically active individuals may be at lower risk of fatal outcomes. However, to date, no meta‐analysis has been carried out to investigate the relationship between physical activity (PA) and fatal outcomes in patients with COVID‐19. Therefore, this meta‐analysis aims to explore the hospitalisation, intensive care unit (ICU) admissions, and mortality rates of COVID‐19 patients with a history of PA participation before the onset of the pandemic, and to evaluate the reliability of the evidence. A systematic search of MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and medRxiv was conducted for articles published up to January 2022. A random‐effects meta‐analysis was performed to compare disease severity and mortality rates of COVID‐19 patients in physically active and inactive cases. Twelve studies involving 1,256,609 patients (991,268 physically active and 265,341 inactive cases) with COVID‐19, were included in the pooled analysis. The overall meta‐analysis compared with inactive controls showed significant associations between PA with reduction in COVID‐19 hospitalisation (risk ratio (RR) = 0.58, 95% confidence intervals (CI) 0.46–0.73, P = 0.001), ICU admissions (RR = 0.65, 95% CI 0.52–0.81, P = 0.001) and mortality (RR = 0.47, 95% CI 0.38–0.59, P = 0.001). The protective effect of PA on COVID‐19 hospitalisation and mortality could be attributable to the types of exercise such as resistance exercise (RR = 0.27, 95% CI 0.15–0.49, P = 0.001) and endurance exercise (RR = 0.41, 95% CI 0.23–0.74, P = 0.003), respectively. Physical activity is associated with decreased hospitalisation, ICU admissions, and mortality rates of patients with COVID‐19. Moreover, COVID‐19 patients with a history of resistance and endurance exercises experience a lower rate of hospitalisation and mortality, respectively. Further studies are warranted to determine the biological mechanisms underlying these findings.

The longitudinal trajectories of cardiac structure and function following SARS‐CoV‐2 infection are unclear. Therefore, this meta‐analysis aims to elucidate the effect of SARS‐CoV‐2 infection on cardiac function in coronavirus disease 2019 (COVID‐19) survivors after recovery. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched for articles published up to 1st August 2022. A systematic review and meta‐analysis were performed to calculate the pooled effects size and 95% confidence interval of each outcome. A total of 21 studies including 2394 individuals (1436 post‐COVID‐19 cases and 958 controls) were included in the present meta‐analysis. The pooled analyses compared with control groups showed a significant association between post‐COVID‐19 and reduced left ventricular ejection fraction (LV EF), LV end‐diastolic volume (LV EDV), LV stroke volume (LV SV), mitral annular plane systolic excursion (MAPSE), global longitudinal strain, right ventricular EF (RV EF), RV EDV, RV ESV, RV SV, tricuspid annular plane systolic excursion, and increased LV mass. Subgroup analysis based on the severity of COVID‐19 in the acute phase and subsequent chronic outcomes revealed that LV EF, MAPSE, RV EF, and RV ESV only decreased in studies including patients with a history of intensive care unit admission. Cardiac impairment after SARS‐CoV‐2 infection persisted in recovered COVID‐19 patients even after 1 year. Future studies are warranted to determine the biological mechanisms underlying the long‐term cardiovascular consequences of COVID‐19.

Long‐term sequelae conditions of COVID‐19 at least 2‐year following SARS‐CoV‐2 infection are unclear and little is known about their prevalence, longitudinal trajectory, and potential risk factors. Therefore, we conducted a comprehensive meta‐analysis of survivors' health‐related consequences and sequelae at 2‐year following SARS‐CoV‐2 infection. PubMed/MEDLINE, CENTRAL, and EMBASE were systematically searched up to February 10, 2023. A systematic review and meta‐analysis were performed to calculate the pooled effect size, expressed as event rate (ER) with corresponding 95% confidence interval (CI) of each outcome. Twelve studies involving 1 289 044 participants from 11 countries were included. A total of 41.7% of COVID‐19 survivors experienced at least one unresolved symptom and 14.1% were unable to return to work at 2‐year after SARS‐CoV‐2 infection. The most frequent symptoms and investigated findings at 2‐year after SARS‐CoV‐2 infection were fatigue (27.4%; 95% CI 17%–40.9%), sleep difficulties (25.1%; 95% CI 22.4%–27.9%), impaired diffusion capacity for carbon monoxide (24.6%; 95% CI 10.8%–46.9%), hair loss (10.2%; 95% CI 7.3%–14.2%), and dyspnea (10.1%; 95% CI 4.3%–21.9%). Individuals with severe infection suffered more from anxiety (OR = 1.69, 95% CI 1.17–2.44) and had more impairments in forced vital capacity (OR = 9.70, 95% CI 1.94–48.41), total lung capacity (OR = 3.51, 95% CI 1.77–6.99), and residual volume (OR = 3.35, 95% CI 1.85–6.07) after recovery. Existing evidence suggest that participants with a higher risk of long‐term sequelae were older, mostly female, had pre‐existing medical comorbidities, with more severe status, underwent corticosteroid therapy, and higher inflammation at acute infection. Our findings suggest that 2‐year after recovery from SARS‐CoV‐2 infection, 41.7% of survivors still suffer from either neurological, physical, and psychological sequela. These findings indicate that there is an urgent need to preclude persistent or emerging long‐term sequelae and provide intervention strategies to reduce the risk of long COVID.

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