Risk factors associated with Diabetes Mellitus in COVID-19 infected patients: A meta-analytic synthesis of observational studies

Abstract

Aims: We carried out a systematic literature review and meta-analytic synthesis to find out association between DM and related outcomes in patients with COVID-19 infection. Methods: We systematically searched MEDLINE, and Web of Science to identify studies investigating comorbidities, clinical manifestations and resource utilization of diabetic patients exposed with COVID-19 published from inception to January 2021. Meta-analysis was carried out using Review Manager 5.3. Random effects model was used to compute the pooled estimates of odds ratio/mean difference (OR)/(MD) and 95% confidence intervals (CI). Results: Results from the pooled meta-analysis found that CVD, hypertension, AKI, cerebrovascular disease, AKI and ARDS were significantly associated with DM in COVID-19 infected patients compared to non-diabetic patients. There is significant association found between mortality and DM compared to non-diabetic patients [OR (95% CI): 2.46 (1.68, 3.58)]. ICU admission and use of mechanical ventilation was significantly associated with DM and COVID-19 vs. non-diabetic [OR (95% CI): 2.79 (1.79,4.34) and 3.33 (2.05, 5.42)] respectively. However, LOS, hospitalization, and ICU admission were not significantly differing between diabetes vs. non-diabetes. Conclusions: The results showed a significant association between mortality and DM exposed with COVID-19. Other co-morbidities especially CVD/hypertension could be a serious threat for DM COVID-19 infected patients for the higher mortality.