Insulin Treatment May Increase Adverse Outcomes in Patients With COVID-19 and Diabetes: A Systematic Review and Meta-Analysis.
Insulin Treatment May Increase Adverse Outcomes in Patients With COVID-19 and Diabetes: A Systematic Review and Meta-Analysis.
复制标题
胰岛素治疗可能会增加 COVID-19 和糖尿病患者的不良后果：系统评价和荟萃分析
DOI：
10.3389/fendo.2021.696087
复制
发表时间：
2021
影响因子：
5.2
通讯作者：
Zhang J
中科院分区：
文献类型：
--
作者：
Yang Y;Cai Z;Zhang J
背景与目的近期研究发现，胰岛素治疗与2019冠状病毒病（COVID-19）和糖尿病患者的死亡率和其他不良结局增加相关，但结果尚不清楚且存在争议，因此，我们进行了这项荟萃分析。方法检索PubMed、Web of Science、EMBASE和科克伦图书馆4个数据库，检索所有关于胰岛素治疗和COVID-19不良反应的研究，包括死亡率、严重/危重并发症发生率、住院和住院时间。为了评估发表偏倚，使用漏斗图、Begg检验和Egger检验。使用比值比（OR）和95%置信区间（CI）评估胰岛素治疗对死亡率、严重/危重并发症和住院的影响。胰岛素治疗与住院时间之间的相关性通过标准化平均差（SMD）和95% CI计算。结果共纳入18篇文献，涉及12277例COVID-19合并糖尿病患者。胰岛素治疗与死亡风险增加（OR=2.10; 95%CI，1.51-2.93）和重度/危重COVID-19并发症发生率增加（OR=2.56; 95%CI，1.18-5.55）显著相关。此外，胰岛素治疗可能会增加COVID-19合并糖尿病患者的住院率（OR=1.31; 95%CI，1.06-1.61）。然而，根据胰岛素治疗，住院时间无显著差异（SMD=0.21 95% CI，-0.02-0.45）。结论胰岛素治疗可能会增加COVID-19合并糖尿病患者的死亡率和严重/危重并发症，但需要更多大规模研究来证实和探索确切机制。
Background and Objective Recently, insulin treatment has been found to be associated with increased mortality and other adverse outcomes in patients with coronavirus disease 2019 (COVID-19) and diabetes, but the results remain unclear and controversial, therefore, we conducted this meta-analysis. Methods Four databases, namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify all studies concerning insulin treatment and the adverse effects of COVID-19, including mortality, incidence of severe/critical complications, in-hospital admission and hospitalization time. To assess publication bias, funnel plots, Begg’s tests and Egger’s tests were used. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to access the effect of insulin therapy on mortality, severe/critical complications and in-hospital admission. The association between insulin treatment and hospitalization time was calculated by the standardized mean difference (SMD) with 95% CIs. Results Eighteen articles, involving a total of 12277 patients with COVID-19 and diabetes were included. Insulin treatment was significantly associated with an increased risk of mortality (OR=2.10; 95% CI, 1.51-2.93) and incidence of severe/critical COVID-19 complications (OR=2.56; 95% CI, 1.18-5.55). Moreover, insulin therapy may increase in-hospital admission in patients with COVID-19 and diabetes (OR=1.31; 95% CI, 1.06-1.61). However, there was no significant difference in the hospitalization time according to insulin treatment (SMD=0.21 95% CI, -0.02-0.45). Conclusions Insulin treatment may increase mortality and severe/critical complications in patients with COVID-19 and diabetes, but more large-scale studies are needed to confirm and explore the exact mechanism.
登录
查看更多内容
影响因子：
3.1
作者：
Filgueiras LR;Capelozzi VL;Martins JO;Jancar S
通讯作者：
Jancar S
影响因子：
5.8
作者：
O'Malley, Grenye;Ebekozien, Osagie;Levy, Carol J.
通讯作者：
Levy, Carol J.
影响因子：
7.7
作者：
通讯作者：
--
影响因子：
1.4
作者：
Cernigliaro, Achille;Allotta, Alessandra Vincenza;Scondotto, Salvatore
通讯作者：
Scondotto, Salvatore
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.