Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection

Jing Wu, Jingqi Zhang, Xiaohua Sun, Lijuan Wang, Yunfang Xu, Yuanyuan Zhang, Xingxiang Liu, Chen Dong, Jing Wu, Jingqi Zhang, Xiaohua Sun, Lijuan Wang, Yunfang Xu, Yuanyuan Zhang, Xingxiang Liu, Chen Dong

Abstract

Aim: To evaluate the influence of diabetes on the severity and fatality of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.

Materials and methods: The medical records of 66 hospitalized coronavirus disease 2019 (COVID-19) patients were collected and classified into non-severe (mild/moderate cases) and severe (severe/critical cases) groups. Logistic regression analysis was used to estimate the risk of severe COVID-19 (severe/critical infection). In addition, a meta-analysis including published studies reported the impact of diabetes on the severity and fatality of COVID-19. The current study was conducted using fixed effects models.

Results: There were 22 diabetes and 44 non-diabetes cases among the 66 hospitalized COVID-19 patients. Seven patients with diabetes (31.82%) were diagnosed as severe COVID-19 cases, which was significantly higher than that in the non-diabetes group (4/44, 9.09%, P = .033). After adjustment for age and gender, diabetes was significantly associated with COVID-19 severity (OR: 5.29, 95% CI: 1.07-26.02). A meta-analysis further confirmed the positive association between diabetes and COVID-19 severity (pooled OR = 2.58, 95% CI: 1.93-3.45). Moreover, the patients with diabetes infected with SARS-CoV-2 had a 2.95-fold higher risk of fatality compared with those patients without diabetes (95% CI: 1.93-4.53).

Conclusions: Our findings provide new evidence that diabetes is associated with a higher risk of severity and fatality of COVID-19. Therefore, intensive monitoring and antidiabetic therapy should be considered in patients with diabetes with SARS-CoV-2 infection.

Keywords: COVID-19; diabetes; fatality; severity.

Conflict of interest statement

The authors declare no competing interests.

© 2020 John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Meta‐analysis of the associations between diabetes mellitus (DM) and COVID‐19 severity. (A) Forest plot of the COVID‐19 severity for comparison between patients with and without diabetes; (B) sensitivity analysis of the COVID‐19 severity for comparison between patients with and without diabetes after excluding any single study one at a time
FIGURE 2
FIGURE 2
Subgroup analysis of diabetes mellitus (DM) and the risk of COVID‐19 severity (age 

FIGURE 3

Meta‐analysis of the associations between…

FIGURE 3

Meta‐analysis of the associations between diabetes mellitus (DM) and COVID‐19 fatality. (A) Forest…

FIGURE 3
Meta‐analysis of the associations between diabetes mellitus (DM) and COVID‐19 fatality. (A) Forest plot of the COVID‐19 fatality for comparison between patients with and without diabetes; (B) sensitivity analysis of the COVID‐19 fatality for comparison between patients with and without diabetes after excluding any single study one at a time

FIGURE 4

Subgroup analysis of diabetes mellitus…

FIGURE 4

Subgroup analysis of diabetes mellitus (DM) and risk of COVID‐19 fatality (age

FIGURE 4
Subgroup analysis of diabetes mellitus (DM) and risk of COVID‐19 fatality (age 
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FIGURE 3
FIGURE 3
Meta‐analysis of the associations between diabetes mellitus (DM) and COVID‐19 fatality. (A) Forest plot of the COVID‐19 fatality for comparison between patients with and without diabetes; (B) sensitivity analysis of the COVID‐19 fatality for comparison between patients with and without diabetes after excluding any single study one at a time
FIGURE 4
FIGURE 4
Subgroup analysis of diabetes mellitus (DM) and risk of COVID‐19 fatality (age 

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