Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis.
Identifieur interne : 000661 ( Main/Exploration ); précédent : 000660; suivant : 000662Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis.
Auteurs : Larry E. Miller ; Ruemon Bhattacharyya ; Anna L. MillerSource :
- Medicine [ 1536-5964 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Betacoronavirus (MeSH), Complications du diabète (mortalité), Complications du diabète (virologie), Diabète (mortalité), Diabète (virologie), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (mortalité), Infections à coronavirus (virologie), Mortalité hospitalière (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (mortalité), Pneumopathie virale (virologie), Prévalence (MeSH), Sujet âgé (MeSH).
- MESH :
- mortalité : Complications du diabète, Diabète, Infections à coronavirus, Pneumopathie virale.
- virologie : Complications du diabète, Diabète, Infections à coronavirus, Pneumopathie virale.
- complications : Adulte, Adulte d'âge moyen, Betacoronavirus, Facteurs de risque, Femelle, Humains, Infections à coronavirus, Mortalité hospitalière, Mâle, Pandémies, Pneumopathie virale, Prévalence, Sujet âgé.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (complications), Coronavirus Infections (mortality), Coronavirus Infections (virology), Diabetes Complications (mortality), Diabetes Complications (virology), Diabetes Mellitus (mortality), Diabetes Mellitus (virology), Female (MeSH), Hospital Mortality (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (mortality), Pneumonia, Viral (virology), Prevalence (MeSH), Risk Factors (MeSH).
- MESH :
- complications : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Diabetes Complications, Diabetes Mellitus, Pneumonia, Viral.
- virology : Coronavirus Infections, Diabetes Complications, Diabetes Mellitus, Pneumonia, Viral.
- Adult, Aged, Betacoronavirus, Female, Hospital Mortality, Humans, Male, Middle Aged, Pandemics, Prevalence, Risk Factors.
Abstract
BACKGROUND
The mortality rate associated with Covid-19 varies considerably among studies and determinants of this variability are not well characterized.
METHODS
A systematic review of peer-reviewed literature published through March 31, 2020 was performed to estimate the mortality rate among hospitalized patients in China with a confirmed diagnosis of Covid-19. Hospital mortality rates were estimated using an inverse variance-weighted random-effects meta-analysis model. Funnel plot symmetry was evaluated for small-study effects, a one-study removed sensitivity analysis assessed the influence of individual studies on the pooled mortality rate, and metaregression assessed the association of potential confounding variables with mortality rates.
RESULTS
The review included 16 observational studies involving 1832 hospitalized patients with a diagnosis of Covid-19. The surveillance period among studies ranged from December 16, 2019 to February 23, 2020. The median patient age was 53 years and 53% were males. A total of 38.5% of patients presented with at least 1 comorbidity, most commonly hypertension (24.0%), cardiac disease (15.1%), and diabetes mellitus (14.4%). Fever and cough, reported in 84.8% and 61.7% of patients respectively, were the most common patient symptoms. The pooled mortality rate was 9.9% (95% confidence interval 6.1% to 14.5%). Funnel plot asymmetry was not observed and the meta-analysis results were not substantially influenced by any single study since the pooled mortality rate ranged from 8.9% to 11.1% following iterative removal of one study at a time. Substantial heterogeneity in the mortality rate was identified among studies (I = 87%; P < .001). In a metaregression that included demographics, patient risk factors, and presenting symptoms, only a higher prevalence of diabetes mellitus was associated with a higher mortality rate (P = .03).
CONCLUSIONS
In a meta-analysis of hospitalized patients in China with a diagnosis of Covid-19, the mortality rate was 9.9% and a higher diabetes mellitus prevalence was independently associated with a worse prognosis. The independent influence of diabetes mellitus with Covid-19 mortality should be viewed as hypothesis-generating and warrants further study.
DOI: 10.1097/MD.0000000000022439
PubMed: 33019426
Affiliations:
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Miller</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33019426</idno><idno type="pmid">33019426</idno><idno type="doi">10.1097/MD.0000000000022439</idno><idno type="wicri:Area/Main/Corpus">000018</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000018</idno><idno type="wicri:Area/Main/Curation">000018</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000018</idno><idno type="wicri:Area/Main/Exploration">000018</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis.</title><author><name sortKey="Miller, Larry E" sort="Miller, Larry E" uniqKey="Miller L" first="Larry E" last="Miller">Larry E. Miller</name></author><author><name sortKey="Bhattacharyya, Ruemon" sort="Bhattacharyya, Ruemon" uniqKey="Bhattacharyya R" first="Ruemon" last="Bhattacharyya">Ruemon Bhattacharyya</name></author><author><name sortKey="Miller, Anna L" sort="Miller, Anna L" uniqKey="Miller A" first="Anna L" last="Miller">Anna L. Miller</name></author></analytic><series><title level="j">Medicine</title><idno type="eISSN">1536-5964</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (mortality)</term><term>Coronavirus Infections (virology)</term><term>Diabetes Complications (mortality)</term><term>Diabetes Complications (virology)</term><term>Diabetes Mellitus (mortality)</term><term>Diabetes Mellitus (virology)</term><term>Female (MeSH)</term><term>Hospital Mortality (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (mortality)</term><term>Pneumonia, Viral (virology)</term><term>Prevalence (MeSH)</term><term>Risk Factors (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Betacoronavirus (MeSH)</term><term>Complications du diabète (mortalité)</term><term>Complications du diabète (virologie)</term><term>Diabète (mortalité)</term><term>Diabète (virologie)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (mortalité)</term><term>Infections à coronavirus (virologie)</term><term>Mortalité hospitalière (MeSH)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (mortalité)</term><term>Pneumopathie virale (virologie)</term><term>Prévalence (MeSH)</term><term>Sujet âgé (MeSH)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term><term>Diabetes Complications</term><term>Diabetes Mellitus</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Complications du diabète</term><term>Diabète</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Complications du diabète</term><term>Diabète</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Diabetes Complications</term><term>Diabetes Mellitus</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Betacoronavirus</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Prevalence</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Betacoronavirus</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Infections à coronavirus</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Pandémies</term><term>Pneumopathie virale</term><term>Prévalence</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The mortality rate associated with Covid-19 varies considerably among studies and determinants of this variability are not well characterized.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A systematic review of peer-reviewed literature published through March 31, 2020 was performed to estimate the mortality rate among hospitalized patients in China with a confirmed diagnosis of Covid-19. Hospital mortality rates were estimated using an inverse variance-weighted random-effects meta-analysis model. Funnel plot symmetry was evaluated for small-study effects, a one-study removed sensitivity analysis assessed the influence of individual studies on the pooled mortality rate, and metaregression assessed the association of potential confounding variables with mortality rates.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The review included 16 observational studies involving 1832 hospitalized patients with a diagnosis of Covid-19. The surveillance period among studies ranged from December 16, 2019 to February 23, 2020. The median patient age was 53 years and 53% were males. A total of 38.5% of patients presented with at least 1 comorbidity, most commonly hypertension (24.0%), cardiac disease (15.1%), and diabetes mellitus (14.4%). Fever and cough, reported in 84.8% and 61.7% of patients respectively, were the most common patient symptoms. The pooled mortality rate was 9.9% (95% confidence interval 6.1% to 14.5%). Funnel plot asymmetry was not observed and the meta-analysis results were not substantially influenced by any single study since the pooled mortality rate ranged from 8.9% to 11.1% following iterative removal of one study at a time. Substantial heterogeneity in the mortality rate was identified among studies (I = 87%; P < .001). In a metaregression that included demographics, patient risk factors, and presenting symptoms, only a higher prevalence of diabetes mellitus was associated with a higher mortality rate (P = .03).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>In a meta-analysis of hospitalized patients in China with a diagnosis of Covid-19, the mortality rate was 9.9% and a higher diabetes mellitus prevalence was independently associated with a worse prognosis. The independent influence of diabetes mellitus with Covid-19 mortality should be viewed as hypothesis-generating and warrants further study.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33019426</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>13</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>13</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-5964</ISSN><JournalIssue CitedMedium="Internet"><Volume>99</Volume><Issue>40</Issue><PubDate><Year>2020</Year><Month>Oct</Month><Day>02</Day></PubDate></JournalIssue><Title>Medicine</Title><ISOAbbreviation>Medicine (Baltimore)</ISOAbbreviation></Journal><ArticleTitle>Diabetes mellitus increases the risk of hospital mortality in patients with Covid-19: Systematic review with meta-analysis.</ArticleTitle><Pagination><MedlinePgn>e22439</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/MD.0000000000022439</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The mortality rate associated with Covid-19 varies considerably among studies and determinants of this variability are not well characterized.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A systematic review of peer-reviewed literature published through March 31, 2020 was performed to estimate the mortality rate among hospitalized patients in China with a confirmed diagnosis of Covid-19. Hospital mortality rates were estimated using an inverse variance-weighted random-effects meta-analysis model. Funnel plot symmetry was evaluated for small-study effects, a one-study removed sensitivity analysis assessed the influence of individual studies on the pooled mortality rate, and metaregression assessed the association of potential confounding variables with mortality rates.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The review included 16 observational studies involving 1832 hospitalized patients with a diagnosis of Covid-19. The surveillance period among studies ranged from December 16, 2019 to February 23, 2020. The median patient age was 53 years and 53% were males. A total of 38.5% of patients presented with at least 1 comorbidity, most commonly hypertension (24.0%), cardiac disease (15.1%), and diabetes mellitus (14.4%). Fever and cough, reported in 84.8% and 61.7% of patients respectively, were the most common patient symptoms. The pooled mortality rate was 9.9% (95% confidence interval 6.1% to 14.5%). Funnel plot asymmetry was not observed and the meta-analysis results were not substantially influenced by any single study since the pooled mortality rate ranged from 8.9% to 11.1% following iterative removal of one study at a time. Substantial heterogeneity in the mortality rate was identified among studies (I = 87%; P < .001). In a metaregression that included demographics, patient risk factors, and presenting symptoms, only a higher prevalence of diabetes mellitus was associated with a higher mortality rate (P = .03).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In a meta-analysis of hospitalized patients in China with a diagnosis of Covid-19, the mortality rate was 9.9% and a higher diabetes mellitus prevalence was independently associated with a worse prognosis. The independent influence of diabetes mellitus with Covid-19 mortality should be viewed as hypothesis-generating and warrants further study.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Larry E</ForeName><Initials>LE</Initials></Author><Author ValidYN="Y"><LastName>Bhattacharyya</LastName><ForeName>Ruemon</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Anna L</ForeName><Initials>AL</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Medicine (Baltimore)</MedlineTA><NlmUniqueID>2985248R</NlmUniqueID><ISSNLinking>0025-7974</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D048909" MajorTopicYN="N">Diabetes Complications</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003920" MajorTopicYN="N">Diabetes Mellitus</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="Y">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>6</Day><Hour>1</Hour><Minute>7</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33019426</ArticleId><ArticleId IdType="doi">10.1097/MD.0000000000022439</ArticleId><ArticleId IdType="pii">00005792-202010020-00048</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list></list><tree><noCountry><name sortKey="Bhattacharyya, Ruemon" sort="Bhattacharyya, Ruemon" uniqKey="Bhattacharyya R" first="Ruemon" last="Bhattacharyya">Ruemon Bhattacharyya</name><name sortKey="Miller, Anna L" sort="Miller, Anna L" uniqKey="Miller A" first="Anna L" last="Miller">Anna L. Miller</name><name sortKey="Miller, Larry E" sort="Miller, Larry E" uniqKey="Miller L" first="Larry E" last="Miller">Larry E. Miller</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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