Diabetes-related acute metabolic emergencies in COVID-19 patients: a systematic review and meta-analysis.
Diabetes-related acute metabolic emergencies in COVID-19 patients: a systematic review and meta-analysis.
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DOI：
10.1007/s13340-021-00502-9
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发表时间：
2021-10
影响因子：
2.2
通讯作者：
Filippou DK
中科院分区：
文献类型：
--
作者：
Papadopoulos VP;Koutroulos MV;Zikoudi DG;Bakola SA;Avramidou P;Touzlatzi N;Filippou DK
COVID-19 与糖尿病酮症酸中毒 (DKA)、高血糖高渗状态 (HHS) 和血糖正常的 DKA (EDKA) 相关；然而，关于影响结果和死亡率的参数的证据很少。使用 EMBASE、PubMed/Medline 和 Google Scholar 于 2020 年 1 月至 2021 年 1 月 7 日进行了系统性文献综述，以确定描述 COVID-19 患者 DKA、HHS、DKA/HHS 和 EDKA 病例临床特征、结果和死亡率的所有研究。使用适当的乔安娜布里格斯研究所工具进行质量评估；使用 GRADE 来衡量证据的质量。根据病例报告，使用单变量和多变量分析来评估临床特征和结果之间的相关性。综合死亡率（CMR）是根据病例报告系列、横断面研究和荟萃分析中报告的数据估计的。该方案已提交给 PROSPERO（ID：229356/230737）。在 312 份已确定的出版物中，对 44 份进行了定性和定量分析。需要 ICU 的危重 COVID-19 (P = 3 × 10–8)、DKA/HHS 存在 (P = 0.021) 和 AKI (P = 0.037) 与死亡独立相关。 COVID-19 严重程度增加 (P = 0.003)、乳酸升高 (P < 0.001)、阴离子间隙增大 (P < 0.001) 和 AKI (P = 0.002) 与 DKA/HHS 相关。 SGLT-2i 与 EDKA 相关（P = 0.004），与 AKI 呈负相关（P = 0.023）。 CMR 为 27.1% (95% CI 11.2–46.9%)，具有相当大的异质性 (I2 = 67%)。 COVID-19患者的急性糖尿病相关代谢紧急情况导致死亡率增加；关键决定因素是严重的 COVID-19 疾病、DKA/HHS 和 AKI 的共存。之前的 SGLT-2i 治疗虽然与 EDKA 相关，但可能会保留 COVID-19 患者的肾功能。在线版本包含可在 10.1007/s13340-021-00502-9 获取的补充材料。
COVID-19 is associated with diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state (HHS) and euglycaemic DKA (EDKA); however, evidence regarding parameters affecting outcome and mortality rates is scarce. A systematic literature review was conducted using EMBASE, PubMed/Medline, and Google Scholar from January 2020 to 7 January 2021 to identify all studies describing clinical profile, outcome and mortality rates regarding DKA, HHS, DKA/HHS and EDKA cases in COVID-19 patients. The appropriate Joanna Briggs Institute tools were used for quality assessment; quality of evidence was approached using GRADE. Univariate and multivariate analyses were used to assess correlations between clinical characteristics and outcome based on case reports. Combined mortality rates (CMR) were estimated from data reported in case report series, cross-sectional studies, and meta-analyses. The protocol was submitted to PROSPERO (ID: 229356/230737). From 312 identified publications, 44 were qualitatively and quantitatively analyzed. Critical COVID-19 necessitating ICU (P = 3 × 10–8), DKA/HHS presence (P = 0.021), and AKI (P = 0.037) were independently correlated with death. Increased COVID-19 severity (P = 0.003), elevated lactates (P < 0.001), augmented anion gap (P < 0.001), and AKI (P = 0.002) were associated with DKA/HHS. SGLT-2i were linked with EDKA (P = 0.004) and negatively associated with AKI (P = 0.023). CMR was 27.1% (95% CI 11.2–46.9%) with considerable heterogeneity (I2 = 67%). Acute diabetes-related metabolic emergencies in COVID-19 patients lead to increased mortality; key determinants are critical COVID-19 illness, coexistence of DKA/HHS and AKI. Previous SGLT-2i treatment, though associated with EDKA, might preserve renal function in COVID-19 patients. The online version contains supplementary material available at 10.1007/s13340-021-00502-9.
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影响因子：
29
作者：
Coate KC;Cha J;Shrestha S;Wang W;Gonçalves LM;Almaça J;Kapp ME;Fasolino M;Morgan A;Dai C;Saunders DC;Bottino R;Aramandla R;Jenkins R;Stein R;Kaestner KH;Vahedi G;HPAP Consortium;Brissova M;Powers AC
通讯作者：
Powers AC
影响因子：
5.1
作者：
Goldman, Nina;Fink, Douglas;Davies, Zoe
通讯作者：
Davies, Zoe
影响因子：
5.1
作者：
Fadini, Gian Paolo;de Kreutzenberg, Saula Vigili;Avogaro, Angelo
通讯作者：
Avogaro, Angelo
DOI：
10.1016/j.dsx.2020.10.015
发表时间：
2020-11
期刊：
Diabetes & metabolic syndrome
影响因子：
--
作者：
Kuchay MS;Reddy PK;Gagneja S;Mathew A;Mishra SK
通讯作者：
Mishra SK
影响因子：
5.2
作者：
Fignani D;Licata G;Brusco N;Nigi L;Grieco GE;Marselli L;Overbergh L;Gysemans C;Colli ML;Marchetti P;Mathieu C;Eizirik DL;Sebastiani G;Dotta F
通讯作者：
Dotta F