Risk For Newly Diagnosed Diabetes Mellitus After COVID-19:a Systematic Review And Meta-analysis

Background:There is growing evidence that patients recovering after a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection may have a variety of acute sequelae including newly diagnosed diabetes mellitus.However,the risk of diabetes in the post-acute phase is unclear.To solve this question,we aimed to determine if there was any association between status post-coronavirus disease(COVID-19)infection and a new diagnosis of diabetes mellitus.Methods:We performed a systematic review and meta-analysis of cohort studies assessing new-onset diabetes mellitus after COVID-19.PubMed,Embase,Web of Science,and Cochrane databases were all searched.Three evaluators independently extracted individual study data and assessed the risk of bias.Random-effects models estimated the pooled incidence and relative risk(RR)of diabetes compared to non-COVID-19 after COVID-19.Results:Nine studies with nearly 40 million participants were included.Overall,the incidence of diabetes after COVID-19 was 15.53(7.91-25.64)per 1000 person-years,and the relative risk of diabetes after COVID-19 infection was elevated(RR 1.62[1.45-1.80]).The relative risk of type 1 diabetes was RR=1.48(1.26-1.75)and type 2 diabetes was RR=1.70(1.32-2.19),compared to non-COVID-19 patients.At all ages,there was a statistically significant positive association between infection with COVID-19 and the risk of diabetes:<18 years:RR=1.72(1.19-2.49),≥18 years:RR=1.63(1.26-2.11),and>65 years:RR=1.68(1.22-2.30).The relative risk of diabetes in different gender groups was about 2(males:RR=2.08[1.27-3.40];females:RR=1.99[1.47-2.80]).The risk of diabetes increased 1.17-fold(1.02-1.34)after COVID-19 infection compared to patients with general upper respiratory tract infections.The risk(RR=1.95[1.85-2.06])of diabetes was highest in the first 3 months after COVID-19.These results remained after taking confounding factors into account.Conclusions:After COVID-19,patients of all ages and genders had an elevated incidence and relative risk for a new diagnosis of diabetes.Particular attention should be paid during the first 3 months of follow-up after COVID-19 for new-onset diabetes.