key: cord-0834693-ok8wgvil authors: Palaiodimos, L.; Chamorro-Pareja, N.; Karamanis, D.; Li, W.; Zavras, P. D.; Mathias, P.; Kokkinidis, D. G. title: Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients date: 2020-05-28 journal: nan DOI: 10.1101/2020.05.26.20113811 sha: 2cf10931839d6b8f4fa1951318866761cf2303a4 doc_id: 834693 cord_uid: ok8wgvil Background: Infectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. Our aim was to systematically review and synthesize with a meta-analysis the available observational studies reporting the effect of diabetes in mortality among hospitalized patients with COVID-19. Methods: Medline, Embase, Google Scholar, and medRxiv databases were reviewed. A random-effect model meta-analysis was used and I-square was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed. Results: 18,506 patients were included in this meta-analysis (3,713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared to patients without diabetes (OR: 1.65; 95% CI: 1.35, 1.96; I2 77.4%). The heterogeneity was high. A study level meta-regression analysis was performed for all the important covariates and no significant interactions were found between the covariates and the outcome of mortality. Conclusion: This meta-analysis shows that that the likelihood of death is 65% higher in diabetic hospitalized patients with COVID-19 compared to non-diabetics. Further studies are needed to assess whether this association is independent or not, as well as to investigate to role of glucose control prior or during the disease. is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 28, 2020. . t h a d j u s t e d a n d u n a d j u s t e d O R s , w e u s e d t h e u n a d j u s t e d e f f e c t e s t i m a t e . W e p e r f o r m e d a m e t a -a n a l y s i s u s i n g t h e r a n d o m e f f e c t is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 28, 2020. . i n t w e l v e s t u d i e s . 4 3 % ( 7 , 9 6 7 ) o f t h e p o p u l a t i o n w a s w o m e n . A m o n g s t u d i e s w h i c h r e p o r t e d t h e i r r e s u l t s i n e v e n t r a t e s , t h e o v e r a l l f r e q u e n c y o f d e a t h e v e n t s i n d i a b e t i c is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 28, 2020. . f o c u s e d o n g e o g r a p h i c a l r e g i o n s o f s t u d y o r i g i n w i t h , o n c e a g a i n , s i g n i f i c a n t h e t e r o g e n e i t y , i i i ) o u r m e t a -r e g r e s s i o n a n a l y s i s d i d n o t s h o w a n a s s o c i a t i o n b e t w e e is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. 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CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 28, 2020. . I n c o n c l u s i o n , t h e p r e s e n t s y s t e m a t i c r e v i e w a n d m e t a -a n a l y s i s r e v e a l e d t h a t t h e l i k e l i h o o d o f d e a t h i s 6 5 % h i g h e r i n d i a b e t i c h o s p i t a l i z e d p a t i e n t s w i t h C O V I D -1 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 28, 2020. . Online supplementary material. Ten graphs of the meta-regression analyses for age, female sex, hypertension, coronary artery disease, heart failure, chronic kidney disease, history of stroke, smoking history, COPD history, and malignancy, respectively. . 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