Diabetes and COVID-19 (multiple reviews)
What is this? If a patient has comorbidities, such as diabetes, this may affect their risk of contracting COVID-19 and the severity of their disease. Several rapid reviews are summarised here. For more details including citations and links to the full reviews, please scroll down this page.
What was found: Pre-existing diabetes is associated with a higher risk of severe disease and mortality in COVID-19 patients.
There is some indication that age influences the increased risk of COVID-19 in people with diabetes, but the evidence from the included reviews is conflicting. Studies included in the Chowdhury review (search done up to 31 May 2020) identified a low risk of death from COVID-19 for type I diabetes patients under 40 years of age, but the Huang review (search done on 8 April 2020) found that the association between diabetes and poor COVID-19 outcomes was stronger in younger patients.
The Chowdhury review (search done up to 31 May 2020) found that diabetes was associated with an increased risk of infection generally but that there was uncertainty about whether type 1 diabetes increases the risk of COVID-19 infection. The authors suggested optimising glycaemic control to help with primary prevention and improving outcomes for COVID-19 patients with type 1 diabetes.
What are the reviews:
Citation: Abdi A, Jalilian M, Sarbarzeh PA, et al. Diabetes and COVID-19: A systematic review on the current evidences. Diabetes Research and Clinical Practice. 2020;166:108347.
In this rapid systematic review, the authors searched for observational studies, opinion pieces and reviews reporting diabetes in COVID-19 patients, which had been published up to 31 March 2020. They included 27 studies, 14 of which were retrospective, mostly from China (76,639 patients with some overlap). They included 18 studies in a meta-analysis.
Citation: Aggarwal G, Lippi G, Lavie CJ, et al. Diabetes mellitus association with coronavirus disease 2019 (COVID‐19) severity and mortality: a pooled analysis. Journal of Diabetes. 2020;12(11):851-5.
In this rapid meta-analysis, the authors searched for studies evaluating associations between diabetes and severity of COVID-19 infection, which had been published up to 31 March 2020. They included 12 studies (2564 patients) that compared history of diabetes in severe and non-severe COVID-19 cases and 4 studies (618 patients) that reported the rate of diabetes in surviving and non-surviving COVID-19 patients.
Citation: Chowdhury S, Goswami S. COVID-19 and type 1 diabetes: dealing with the difficult duo. International Journal of Diabetes in Developing Countries. 2020;40(3):315-20.
In this rapid review, the authors searched for studies on type 1 diabetes and COVID-19. They searched the PubMed database for articles published up to 31 May 2020. They included 18 articles.
Citation: Desai R, Singh S, Parekh T, et al. COVID-19 and diabetes mellitus: A need for prudence in elderly patients from a pooled analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):683-5.
In this rapid review, the authors searched for studies reporting frequency of diabetes in COVID-19 patients. They searched for studies published between December 2019 and March 2020. They included 11 studies (2084 COVID-19 patients) and divided these into 2 groups depending on mean patient age: <50 years (1365 patients) and >50 years (107 patients).
Citation: Guo L, Shi Z, Zhang Y, et al. Comorbid diabetes and the risk of disease severity or death among 8807 COVID-19 patients in China: A meta-analysis. Diabetes research and clinical practice. 2020;166:108346.
In this rapid meta-analysis, the authors searched for studies of the association of diabetes with COVID-19 severity or mortality in adult patients in China. They restricted their searches to articles published in English or Chinese between 1 January and 30 May 2020. They included 9 studies (8807 COVID-19 patients, 1070 with diabetes), mostly from Hubei Province.
Citation: Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia–a systematic review, meta-analysis, and meta-regression. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):395-403.
In this rapid review, the authors searched for studies of the association between diabetes and poor outcome in COVID-19 patients. They restricted their searches to articles published in English and did the final search on 8 April 2020. They included 30 studies (6452 patients), mostly from China.
Citation: Kumar A, Arora A, Sharma P, et al. Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis. Diabetes & Metabolic Syndrome. 2020;14(4):535-45.
In this rapid meta-analysis, the authors searched for case-control studies of the relationship between diabetes and COVID-19. They restricted their searches to articles published in English between 1 January 2020 and 22 April 2020. They included 33 studies (total: 16,003 patients) from China (30 studies), France (1) and the USA (2).
Citation: Parveen R, Sehar N, Bajpai R, et al. Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis. Diabetes Research and Clinical Practice. 2020;166:108295.
In this rapid review, the authors searched for studies of the association between diabetes and hypertension and COVID-19. They restricted their searches to articles published in English up to 31 March 2020. They included 3 cohort studies and 4 case series (total: 2018 patients), all from China.
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