Author: Prattichizzo, Francesco; de Candia, Paola; Nicolucci, Antonio; Ceriello, Antonio
Title: Elevated HbA1c levels in preâ€Covidâ€19 infection increases the risk of mortality: A sistematic review and metaâ€analysis Cord-id: pklxh60l Document date: 2021_5_28
ID: pklxh60l
Snippet: AIMS: Diabetes is emerging as a risk factor for coronavirus disease (COVID)â€19 prognosis. However, contradictory findings have been reported regarding the impact of glycaemic control on COVIDâ€19 outcome. The aim of this metaâ€analysis was to explore the impact of hospital preâ€admission or atâ€admission values of HbA1c on COVIDâ€19 mortality or worsening in patients with diabetes. MATERIALS AND METHODS: We searched PubMed, Embase and Scopus up to 30th December 2020. Eligibility criteria
Document: AIMS: Diabetes is emerging as a risk factor for coronavirus disease (COVID)â€19 prognosis. However, contradictory findings have been reported regarding the impact of glycaemic control on COVIDâ€19 outcome. The aim of this metaâ€analysis was to explore the impact of hospital preâ€admission or atâ€admission values of HbA1c on COVIDâ€19 mortality or worsening in patients with diabetes. MATERIALS AND METHODS: We searched PubMed, Embase and Scopus up to 30th December 2020. Eligibility criteria for study selection were the following: (1)enrolling patients with any form of diabetes mellitus and hospitalized for COVIDâ€19 and (2) reporting data regarding HbA1c values before infection or at hospital admission in relation to COVIDâ€19 mortality or worsening. Descriptive statistics, HbA1c values, odds ratios (ORs) and hazard ratios were extracted from seven observational studies and generic inverse variance (random effects) of OR was used to estimate the effect of HbA1c on COVIDâ€19 outcome. RESULTS: HbA1c was linearly associated with an increased COVIDâ€19 mortality or worsening when considered as a continuous variable (OR 1.01 [1.01, 1.01]; p < 0.00001). Similarly, when analysing studies providing the number of events according to the degree of glycaemic control among various strata, a significantly increased risk was observed with poor glycaemic control (OR 1.15 [1.11, 1.19]; p < 0.00001), a result corroborated by sensitivity analysis. CONCLUSIONS: Notwithstanding the large heterogeneity in study design and patients' characteristics in the few available studies, data suggest that patients with diabetes and poor glycaemic control before infection might have an increased risk of COVIDâ€19 related mortality.
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