Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China: A meta-analysis

Guo, Li; Shi, Zumin; Zhang, Ya Ping; Wang, Cuicui; Moreira, Nayla Cristina do Vale; Zuo, Hui; Hussain, Akhtar

doi:10.1016/j.diabres.2020.108346

Cited by 87 publications

(86 citation statements)

References 40 publications

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“…In our study, diabetes was more common in patients with COVID-19 and was associated with an increased risk of death. This finding is in accordance with a meta-analysis that analyzed the association between comorbid diabetes and disease severity or death [35,36]. As shown in our study, diabetes is one of the most prevalent comorbidities in patients with COVID-19, and there is a significant association with a greater severity of the illness or death in primary care; this association is in line with in-hospital mortality for patients with COVID-19, for which up to a 3-fold increased risk has been found [37].…”

Section: Principal Findingssupporting

confidence: 89%

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Mayer¹,

Vidal-Alaball²,

Puigdellı́vol-Sánchez³

et al. 2021

JMIR Public Health Surveill

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Background The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15). Conclusions We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.

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Section: Principal Findingssupporting

confidence: 89%

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Mayer¹,

Vidal-Alaball²,

Puigdellı́vol-Sánchez³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…However, another study with a larger sample size found that AST abnormality, rather than bilirubin, was strongly associated with COVID-19 mortality risk [ 20 ]. A recent meta-analysis concluded that comorbid diabetes was associated with an increased risk of disease severity or death in Chinese COVID-19 patients, while it is still not clear to what extent diabetes independently contributes to the increased risk [ 21 ]. Besides, acute kidney injury is associated with severe infection and fatality in patients with COVID-19 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a prognostic nomogram for predicting in-hospital mortality of COVID-19: a multicenter retrospective cohort study of 4086 cases in China

Fang

Cheng

et al. 2021

Aging

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To establish an effective nomogram for predicting in-hospital mortality of COVID-19, a retrospective cohort study was conducted in two hospitals in Wuhan, China, with a total of 4,086 hospitalized COVID-19 cases. All patients have reached therapeutic endpoint (death or discharge). First, a total of 3,022 COVID-19 cases in Wuhan Huoshenshan hospital were divided chronologically into two sets, one (1,780 cases, including 47 died) for nomogram modeling and the other (1,242 cases, including 22 died) for internal validation. We then enrolled 1,064 COVID-19 cases (29 died) in Wuhan Taikang-Tongji hospital for external validation. Independent factors included age (HR for per year increment: 1.05), severity at admission (HR for per rank increment: 2.91), dyspnea (HR: 2.18), cardiovascular disease (HR: 3.25), and levels of lactate dehydrogenase (HR: 4.53), total bilirubin (HR: 2.56), blood glucose (HR: 2.56), and urea (HR: 2.14), which were finally selected into the nomogram. The C-index for the internal resampling (0.97, 95% CI: 0.95-0.98), the internal validation (0.96, 95% CI: 0.94-0.98), and the external validation (0.92, 95% CI: 0.86-0.98) demonstrated the fair discrimination ability. The calibration plots showed optimal agreement between nomogram prediction and actual observation. We established and validated a novel prognostic nomogram that could predict in-hospital mortality of COVID-19 patients.

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“…Diabetes is a common comorbidity in COVID‐19 patients 5 and was suggested to be a risk factor of severe and fatal COVID‐19 cases 12 . A meta‐analysis showed that COVID‐19 patients with diabetes had a higher risk (risk ratio [RR]: 2.96; 95% CI: 2.31−3.79) of severe disease or death, 69 and higher rate of ICU admissions 70 . In a cohort study of COVID‐19 patients from New York City (USA), those with diabetes had an increased risk of hospital admission (OR: 2.24; 95%CI: 1.84−2.73) and critical illness (OR: 1.24; 95%CI: 1.03‐1.50) 50 .…”

Section: Comorbiditiesmentioning

confidence: 99%

Risk factors for severe and critically ill COVID‐19 patients: A review

Gao

Ding

Dong

et al. 2020

Allergy

1,166

864

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The pandemic of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID‐19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID‐19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high‐sensitivity C‐reactive protein, proinflammatory cytokines such as interleukin (IL)‐6, IL‐1β, Krebs von den Lungen‐6 (KL‐6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID‐19.

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Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China: A meta-analysis

Cited by 87 publications

References 40 publications

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study

Development and validation of a prognostic nomogram for predicting in-hospital mortality of COVID-19: a multicenter retrospective cohort study of 4086 cases in China

Risk factors for severe and critically ill COVID‐19 patients: A review

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