MORTALITY IN PATIENTS WITH DIABETES BY COVID 19 A SYSTEMATIC REVIEW

Abstract

The objective was to carry out a systematic review of what has been published so far on mortality in patients with COVID-19 associated with diabetes comorbidity. A search was carried out in PubMed, Ovid MEDLINE, EMBASE and EMBASE Classic and  Google Scholar databases; up to April 2020 using the search medical subheading (MeSH) terms: "mortality from Coronavirus", "mortality from COVID-19" and "mortality in patients with diabetes by COVID-19". Enrolled studies were assessed independently by two blinded researchers. Studies quality was assessed using the Jedad scale. The articles score equal to or greater than two points were considered high methodological quality. Initially, 65 articles were found and 46 were excluded for not meeting the eligibility criteria. Among the 10 remaining, 3 were excluded because they had a Jedad score lower than two points. Among the remaining seven, two were excluded because they were meta-analysis. Eventually, five articles remained for final analysis. For all, mortality among patients with diabetes was higher than without it. The risk of global mortality among diabetic patients was 8.9 times higher (p<0.0001) than the ones without diabetes. The time of diagnosis could be more determining for mortality, meanwhile HB1Ac level was not determining. It is concluded that the mortality risk observed by COVID-19 is higher among diabetic patients than healthy age matched peers. This result can be partially explained by hormonal signaling changes, such as blood clotting and abnormal pancreas functioning.