RESUMEN
BACKGROUND: SGLT-2 inhibitors, prescribed for type 2 diabetes, have a heightened risk of amputation. The FDA issued a warning in May 2017, leading to the inclusion of a cautionary label. Vigilance is essential for patients and healthcare providers to promptly identify and address potential limb complications associated with the use of SGLT-2 inhibitors. METHOD: A comprehensive search of electronic databases was conducted, covering the period from inception to May 2024. This systematic literature review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included studies was assessed using the Cochrane risk of bias (ROB) tool. Inclusion and exclusion criteria were predefined, and data extraction was performed to summarize the findings. RESULT: A total of 12 randomized control trial (RCT) studies were included in the present systematic review. 37,657 (54.89%) participants were randomly assigned to receive the different interventions of SGLT-2 inhibitor, whereas 30,959 (45.11%) received a placebo. Overall, 618 events were reported in the treatment group, whereas 396 events were reported in the placebo group. CONCLUSION: In conclusion, patients treated with SGLT-2 inhibitors did not have any significant difference in amputation occurrences compared to placebo across various studies. However, canagliflozin usage has led to higher amputation events in certain trials.
RESUMEN
Key Clinical Message: Accurately identifying the ruptured aneurysm in patients with subarachnoid hemorrhage and multiple aneurysms is critical to prevent rebleeding and optimize outcomes. Vessel wall MRI with contrast can aid in pinpointing the culprit aneurysm, informing a tailored surgical or endovascular management strategy for these complex cases. In patients with subarachnoid hemorrhage (SAH) and multiple intracranial aneurysms, MRI with contrast and DSA are crucial for identifying the ruptured aneurysm, guiding a shift from endovascular to microsurgical clipping. Successful single-session treatment and absence of postsurgical deficits highlight the effectiveness of a multidisciplinary approach. Further research on optimal strategies is needed. Abstract: Multiple intracranial aneurysms make up approximately 20% of cases of aneurysmal SAH. In patients with aneurysmal SAH and multiple intracranial aneurysms, definite treatment of the ruptured aneurysm causing SAH is of the highest priority. However, identifying the bleeding source can be challenging, and it may not be recognizable by the hemorrhage pattern. Misdiagnosis and mistreatment of a ruptured aneurysm in a patient with multiple aneurysms can lead to bleeding recurrence and an undesirable outcome. We report a 65-year-old woman who presented with severe sudden onset headache. Neuroimaging studies revealed diffuse SAH and concurrent PICA and ACom aneurysm with triplicate A2. However, the ruptured aneurysm responsible for the patient's symptoms was not obvious based on routine neuroimaging studies. Magnetic resonance imaging with contrast was performed, revealing circumferential enhancement of the PICA aneurysm. In this report, we demonstrate the real-world effect of vessel wall MRI with contrast on decision-making regarding identifying the ruptured aneurysm and surgical planning in cases of multiple aneurysms. Furthermore, we show that MRI and aneurysm wall enhancement could be a promising option in detecting ruptured aneurysms in cases of multiple aneurysms.
RESUMEN
Interleukin-6 (IL-6), a pro-inflammatory cytokine, plays a crucial role in host immune defense and acute stress responses. Moreover, it modulates various cellular processes, including proliferation, apoptosis, angiogenesis, and differentiation. These effects are facilitated by various signaling pathways, particularly the signal transducer and activator of transcription 3 (STAT3) and Janus kinase 2 (JAK2). However, excessive IL-6 production and dysregulated signaling are associated with various cancers, promoting tumorigenesis by influencing all cancer hallmarks, such as apoptosis, survival, proliferation, angiogenesis, invasiveness, metastasis, and notably, metabolism. Emerging evidence indicates that selective inhibition of the IL-6 signaling pathway yields therapeutic benefits across diverse malignancies, such as multiple myeloma, prostate, colorectal, renal, ovarian, and lung cancers. Targeting key components of IL-6 signaling, such as IL-6Rs, gp130, STAT3, and JAK via monoclonal antibodies (mAbs) or small molecules, is a heavily researched approach in preclinical cancer studies. The purpose of this study is to offer an overview of the role of IL-6 and its signaling pathway in various cancer types. Furthermore, we discussed current preclinical and clinical studies focusing on targeting IL-6 signaling as a therapeutic strategy for various types of cancer.
Asunto(s)
Interleucina-6 , Neoplasias , Transducción de Señal , Humanos , Interleucina-6/metabolismo , Interleucina-6/antagonistas & inhibidores , Neoplasias/metabolismo , Neoplasias/inmunología , Neoplasias/patología , Neoplasias/tratamiento farmacológico , Animales , Progresión de la Enfermedad , Factor de Transcripción STAT3/metabolismo , Antineoplásicos/uso terapéuticoRESUMEN
BACKGROUND: Ophthalmic artery aneurysm (OAA) can be secured in endovascular or microsurgical approaches. Still there are controversies in technique selection and their long term outcomes. METHODS: All the patients with OAA were treated microsurgically and followed. Demographic data, neurological status, physical examination findings, angiographic data, operation details, and intraoperative and postoperative events were recorded and analyzed. P < 0.05 was considered significant. RESULTS: Among 55 patients, 38 were females (69.1%). Median preoperative glasgow coma scale (GCS), Fisher Grade, and Hunt and Hess(HH) scores were 15, 1 and 1, respectively. The most common neurologic manifestation was visual problems (n = 15). The most common anatomical projection was medial (43.6%) oriented lesions. 85.5% of them only had 1 ophthalmic aneurysm while multiple aneurysms were reported in 14.6%. In 52 patients temporary clip was used. in 21 patients (38.2%) intraoperative aneurysm rupture occurred. Larger aneurysm size and preoperative hydrocephalus were associated with higher rates of aneurysm rupture (P = 0.003 and 0.031). 28.5% of the patients with visual problems had clinical improvement in the postoperative period. The mean follow-up period was 5 years. Follow-up angiography showed a 100% obliteration rate with a 0.0% recurrence rate. Median values for follow-up glasgow outcome scale and modified Rankin scale were 5 and 0, respectively. favorable neurological outcomes were associated with better primary GCS and HH scores. CONCLUSION: OAA microsurgery is an effective and safe procedure with significant improvement in both visual and neurological status. Low recurrence rate and excellent clinical recovery are the most important advantages of microsurgery in OAA treatment.
Asunto(s)
Aneurisma Intracraneal , Microcirugia , Arteria Oftálmica , Humanos , Femenino , Masculino , Microcirugia/métodos , Persona de Mediana Edad , Arteria Oftálmica/cirugía , Adulto , Estudios de Seguimiento , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/complicaciones , Anciano , Resultado del Tratamiento , Estudios Retrospectivos , Adulto Joven , AdolescenteRESUMEN
Background: Effective skin rejuvenation treatments with RF technologies exist, with potential for personalized combination therapies based on individual factors. We compared microneedling and fractional RF laser effectiveness in rejuvenation, pore healing, and skin lightening. Method: The research was a non-randomized clinical trial study conducted in 2021 at Ilam Skin Clinic, Ilam, western Iran on people applying for rejuvenation, skin lightening and improvement of open pores. People were voluntarily divided into two groups based on personal preferences (group A: microneedling, 25 people, group B: fractional RF, 25 people). After data collection, SPSS22 software was used for data analysis. Results: The study revealed significant differences in the rates of low, moderate, and severe pain between the microneedling and fractional groups (10 vs. 16, 14 vs. 4, 1 vs. 5, respectively). Erythema showed no significant difference, with low, moderate, and severe cases reported in both groups. Swelling was lower in the microneedling group, but the difference was not significant. Bruising was similar in both groups, and staining was minimal. No herpes or infections were reported. The microneedling group showed better improvement in skin pores and skin lightening compared to the fractional group, with outcomes rated as good and excellent. Conclusion: Microneedling surpassed the fractional group in skin rejuvenation, lightening, and improved pores. Considering RF lasers are approximately three times more expensive than microneedling, the research indicates that choosing microneedling is not only more cost-effective but also a superior rejuvenation technique.
RESUMEN
Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p -values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.
RESUMEN
BACKGROUND: Intracranial aneurysms are more commonly associated with inflammation as a cause of their development, progression, and rupture. Macrophages and other cells can express the CD68 antigen. The aim of this study was to assess the CD68 antigen levels in cerebral aneurysm (CA) patients compared to a control group at a referral center in Iran. METHODS: A case-control investigation was undertaken on 88 individuals (44 of whom were cases and 44 were controls). Individuals with CA as the case group consisted of 28 ruptured and 16 unruptured subgroups. Clinical, radiographic, and CD68 levels were evaluated and registered. RESULTS: The average age of the participants was 49 years. Males comprised 43.2% of the patients, while 56.8% were females (p = 0.002). There was a statistically significant difference in the CD68 levels between the two groups. There was no significant difference (p = 0.42) between the ruptured and unruptured subgroups (23.66 and 20.47, respectively) in this comparison. No significant correlation was seen between the patients' CD68 and Glasgow Coma Scale (GCS) levels and their aneurysm diameter (p = 0.74 and 0.45, respectively). A link between CD68 levels and age was found, but it was not statistically significant (r = 0.44 and p = 0.002). CONCLUSIONS: A possible involvement of CD68 as an inflammatory agent in the development of CAs but not in aneurysm rupture has been suggested. Inflammation and CD68 were positively associated with age. The CD68 antigen should be studied further in population-based cohort studies.
Asunto(s)
Aneurisma Roto , Aneurisma Intracraneal , Masculino , Femenino , Humanos , Persona de Mediana Edad , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/complicaciones , Estudios de Casos y Controles , Molécula CD68 , Aneurisma Roto/complicaciones , Inflamación/complicaciones , Antígenos CD , Antígenos de Diferenciación Mielomonocítica , Estudios RetrospectivosRESUMEN
This study introduced a new microextraction method named temperature-induced dispersive solid-phase extraction. The performance of the method was demonstrated with the determination of Sudan dyes in food and natural water samples. In this method, a low quantity of sorbent was added to the aqueous solution and the mixture was shaken manually for about one minute. Then, the solution was heated in an ultrasonic water bath, and the sorbent was dissolved. Subsequently, the solution was cooled down with ice water, and consequently, the solubility of the sorbent was reduced in the sample solution and became cloudy. The phase separation was accelerated by centrifugation. The upper liquid phase was picked up using a syringe, and the remainder was solved in methanol and introduced into the HPLC for analysis. Various parameters affecting the extraction yield were evaluated. Analytical parameters, including limits of detection (0.011-0.016 µg/L) and quantification (0.038-0.055 µg/L), relative standard deviations (2.3%-3.1%), and preconcentration factor (40) proved the high efficiency of the developed method for the analysis of Sudan dyes. The proposed method was used to measure Sudan dyes in water and food samples and showed good extraction recoveries (95.0%-103.5%).
Asunto(s)
Cromatografía Líquida de Alta Presión , Extracción en Fase Sólida , Temperatura , Concentración de Iones de Hidrógeno , Extracción en Fase Sólida/métodos , Colorantes/química , Cromatografía Líquida de Alta Presión/métodos , Agua/química , Análisis de los AlimentosRESUMEN
Arteriovenous fistula and spinal aneurysms like other vascular malformations can mimic radiculopathy and low back pain. Precise imaging work combined with a hybrid endovascular-microsurgical approach is the key element for the best clinical outcome.
RESUMEN
Posterior fossa tumors (PFTs) are prevalent in children, and about half of all childhood brain tumors arise from the structures of the posterior fossa. Studies on PFTs in Iranian children have mainly focused on epidemiological characteristics. This study aimed to evaluate surgical outcomes and predictive factors for survival in children with PFTs in Shiraz, Iran. A prospective cohort study was conducted from March 2014 to September 2019 in Namazi Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran). A total of 87 pediatric patients under the age of 16 who were diagnosed with PFT and had undergone surgery were recruited. The children were followed up for postoperative outcomes such as mortality and neurological complications. Data were analyzed using SPSS software (version 20.0) and R software (version 3.3.1). P<0.05 was considered statistically significant. The mean age of the patients was 6.49±4.14 years and 64.4% were male. Sixteen patients were lost to follow-up, 31 died after surgery, and 40 were in remission during phone calls. The median survival time of the patients was four years. The most common type of PFT was medulloblastoma (n=46, 53%). The result of the multivariate Cox proportional hazards model showed that age (P=0.034) was correlated with postoperative survival, hazard ratio 0.90 (95% confidence interval 0.82 to 0.99). Among various predictive factors, lower age was associated with poor outcomes in pediatric children with PFTs.
Asunto(s)
Neoplasias Cerebelosas , Neoplasias Infratentoriales , Humanos , Niño , Masculino , Preescolar , Femenino , Irán/epidemiología , Estudios Prospectivos , Neoplasias Infratentoriales/cirugía , Resultado del TratamientoRESUMEN
Polyphenols are effective in eliminating amyloid-beta aggregations, the main hallmark of Alzheimer's disease. Various nano drugs and biomaterials based on polyphenolic compounds have been synthetized to treat or prevent Alzheimer's disease, and the main in-vitro approach to investigate the anti-Alzheimer's properties of materials, is the Thioflavin T assay. While useful it has drawbacks and in particular cannot always guarantee the accuracy of data, specifically in cases of polyphenolic compounds; thus, in this situation accurate results requires utilizing other assays along with Thioflavin T. In this experiment, we introduced the Z-scan technique as a complementary test for Thioflavin T assay. In this study, the anti-Alzheimer's properties of two polyphenols quercetin and fulvic acid were assessed in the presence and absences of silver nanoparticles at various concentrations, both via Z-scan technique and Thioflavin T assay, after which the two tests were aligned with each other. The polyphenols' non-linear refractive indices obtained by the Z-scan technique correlated well with their related fluorescence intensities from the Thioflavin T assay in such a way that, the smaller the magnitude of the non-linear refractive indices, the stronger the anti-amyloidogenic impact. Our work shows that Z-scan could be used along with Thioflavin T for enhanced investigation of polyphenols' anti-Alzheimer's properties.
Asunto(s)
Enfermedad de Alzheimer , Nanopartículas del Metal , Fotoquimioterapia , Enfermedad de Alzheimer/tratamiento farmacológico , Benzotiazoles , Humanos , Fotoquimioterapia/métodos , Polifenoles/farmacología , Polifenoles/uso terapéutico , PlataRESUMEN
AIM: To examine the screening value of the serum level of interleukin-1ß (IL-1ß) in aneurysmal subarachnoid hemorrhage (SAH), and to evaluate its association with the severity of initial bleeding. MATERIAL AND METHODS: This case-control study was performed in Namazi Hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study population included patients referred to Namazi Hospital with a diagnosis of SAH, whose symptoms had emerged within less than 48 hours. The case group consisted of patients with cerebral aneurysms, who were divided into two groups of raptured and un-raptured brain aneurysms. This study examined the relationship between the serum IL-1ß levels and brain aneurysms. The number of samples was 43 per group and 86 in total. Forty-eight hours before the onset of symptoms and before surgery, a blood sample was collected to measure the IL-1Β antibody (anti-IL-1ß) level; in less than three hours, the serum was isolated and placed in a -80ºC freezer. RESULTS: In patients with unruptured aneurysms, the Fisher's grade was 0, while most ruptured aneurysms were grade 3. The middle cerebral artery (MCA) (n=10, 23%) was the most common site of aneurysm, followed by the anterior communicating artery (ACom) (n=9, 20%). There was a significant correlation between ruptured aneurysms and the Glasgow Comma Scale (GCS) score (p=0.01) and also Fisher's classification (p=0.04). Patients with ruptured and unruptured aneurysms showed no significant differences regarding the serum IL-1ß levels. A significant difference was found in the serum level of IL-1ß between the case and control groups (p=0.04). CONCLUSION: Generally, knowledge of the association between aneurysm development and inflammatory response can have significant clinical implications in the future. The present findings suggested a significant correlation between the IL-1ß levels and the outcomes of aneurysmal SAH, independent of initial hemorrhage.
Asunto(s)
Aneurisma Roto , Aneurisma Intracraneal , Hemorragia Subaracnoidea , Aneurisma Roto/cirugía , Estudios de Casos y Controles , Grupos Control , Humanos , Interleucina-1beta , Aneurisma Intracraneal/cirugía , Hemorragia Subaracnoidea/complicacionesRESUMEN
Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types ofmicroorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in nontraumatic patients. Multiple brain abscesses are not common. Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition. Conclusion Brain injurywith air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.
Asunto(s)
Humanos , Masculino , Niño , Infecciones Estreptocócicas/tratamiento farmacológico , Heridas por Arma de Fuego/cirugía , Absceso Encefálico/cirugía , Lesiones Traumáticas del Encéfalo/cirugía , Lesiones Traumáticas del Encéfalo/etiología , Fracturas Craneales/cirugía , Fracturas Craneales/etiología , Fracturas Craneales/diagnóstico por imagen , Streptococcus/patogenicidad , Absceso Encefálico/etiología , Absceso Encefálico/diagnóstico por imagenRESUMEN
Letter to the Editor-in-Chief in response to JOSPT article "Dry needling adds no benefit to the treatment of neck pain: a sham-controlled randomized clinical trial with 1-year follow-up" by Gattie et al.J Orthop Sports Phys Ther 2021;51(9):470-471. doi:10.2519/jospt.2021.0202.
Asunto(s)
Punción Seca , Humanos , Dolor de CuelloRESUMEN
Introduction The pineal gland is a common location for intracranial germ cells, but dermoids are not commonly observed in this area. In the present paper, we discuss the clinical and radiological features as well as the treatment and outcome of this cyst in a 6-year- old child with a pineal dermoid cyst. Case Presentation The patient presented with chronic headache 6 months before admission in 2018. On the first admission, an enhanced lesion with a small cyst was detected in brain imaging. Magnetic resonance imaging (MRI) of the brain at follow-up (2 months after the first presentation) showed enlargement of the cyst size with compression on the adjacent structures. Radical excision of the tumor was performed after the endoscopic biopsy due to pressure exerted on the adjacent structures. Conclusion Dermoid cyst should be considered as a differential diagnosis for enhanced lesions of the pineal region.
Asunto(s)
Humanos , Masculino , Niño , Glándula Pineal/lesiones , Neoplasias Glandulares y Epiteliales/cirugía , Quiste Dermoide/cirugía , Quiste Dermoide/patología , Glándula Pineal/cirugía , Glándula Pineal/patología , Continuidad de la Atención al Paciente , Quiste Dermoide/diagnóstico por imagen , Endoscopía/métodosRESUMEN
BACKGROUND: Evidence from real-world studies have suggested a reduced rate of macrovascular complications following bariatric surgery. We undertook this meta-analysis to investigate the impact of bariatric surgery on macrovascular disease outcomes in severely obese type 2 diabetes mellitus (T2DM) patients. METHODS: An extensive literature search was performed in PubMed from inception until March 2020. All cohort studies assessing the association between bariatric surgery and macrovascular complications in severely obese T2DM patients were included. Two independent reviewers screened the articles, extracted data, and assessed the quality using the Newcastle-Ottawa Scale. The primary outcome was to assess the impact of bariatric surgery and the risk of macrovascular complications. Statistical analysis was performed using Review Manager 5.3. RESULTS: This meta-analysis comprised of five studies including 49,211 participants (75% female), of which 14,434 underwent bariatric surgery and 34,777 underwent usual care. Participants who underwent bariatric surgery had a significantly lower risk of macrovascular complications as compared to those with non-surgical interventions (RR: 0.50 [95% CI: 0.35-0.73], p = 0.0003). In the subgroup analysis, based on the geographical regions, studies conducted in the USA showed a higher reduction (RR: 0.41 [95% CI: 0.32-0.53], p < 0.00001) in macrovascular complications as compared to other parts of the world. The risk of all-cause mortality was also significantly lower in patients with bariatric surgery (RR 0.39 [95% CI: 0.30-0.50], p < 0.00001). CONCLUSION: Bariatric surgery was associated with a 50% reduction in macrovascular complications along with 61% reduction in risk of all-cause mortality in morbidly obese T2DM patients.
Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2 , Obesidad Mórbida , Enfermedades Vasculares , Estudios de Cohortes , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/cirugía , Femenino , Humanos , Masculino , Obesidad Mórbida/cirugía , Enfermedades Vasculares/etiologíaRESUMEN
The presence of end-of-life vehicles (ELV) in the cities creates irreparable damage in environmental and economic terms. Thus, governments have been searching for ways to collect ELVs. An effective way to address ELVs is subsidies' policy. In this study, a supply chain including an ELV take-back center, an inspection center, and a repair center are considered. The decision variables are the purchase price of the ELVs, the sale price of the repaired vehicle, and the level of vehicle repair. In this supply chain, the government pays a subsidy to take-back centers that deliver their used vehicles. A Stackelberg game structure is considered with the government as the leader, the inspection center as the primary follower, and the collection and repair centers as the second followers. Using the game theory approach, the effects of government subsidies on equilibrium values of the decision-making variables of the centers in the ELV supply chain have been investigated in three scenarios. The scenarios comprise profit sharing, revenue sharing, and a centralized (cooperative) scenario. The results indicate that the centralized scenario has the most significant advantage compared to the two contracts of profit sharing and cost sharing. For example, the repair level of the ELVs, the amount of repaired vehicles demand, consumer surplus, and the whole supply chain's profit are at their maximum. The most significant impact of subsidy payment is related to the take-back center's profit and the ELV supply. On the other hand, the subsidy does not affect the profit of the repair center.
Asunto(s)
Comercio , Comportamiento del Consumidor , Costos y Análisis de Costo , Técnicas de Apoyo para la Decisión , Financiación GubernamentalRESUMEN
BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) spreads rapidly and within no time, it has been declared a pandemic by the World Health Organization. Evidence suggests diabetes to be a risk factor for the progression and poor prognosis of COVID-19. Therefore, we aimed to understand the pooled prevalence of diabetes in patients infected with COVID-19. We also aimed to compute the risk of mortality and ICU admissions in COVID-19 patients with and without diabetes. METHODS: A comprehensive literature search was performed in PubMed to identify the articles reporting the diabetes prevalence and risk of mortality or ICU admission in COVID-19 patients. The primary outcome was to compute the pooled prevalence of diabetes in COVID-19 patients. Secondary outcomes included risk of mortality and ICU admissions in COVID-19 patients with diabetes compared to patients without diabetes. RESULTS: This meta-analysis was based on a total of 23007 patients from 43 studies. The pooled prevalence of diabetes in patients infected with COVID-19 was found to be 15% (95% CI: 12%-18%), p = <0.0001. Mortality risk was found to be significantly higher in COVID-19 patients with diabetes as compared to COVID-19 patients without diabetes with a pooled risk ratio of 1.61 (95% CI: 1.16-2.25%), p = 0.005. Likewise, risk of ICU admission rate was significantly higher in COVID-19 patients with diabetes as compared to COVID-19 patients without diabetes with a pooled risk ratio of 1.88 (1.20%-2.93%), p = 0.006. CONCLUSION: This meta-analysis found a high prevalence of diabetes and higher mortality and ICU admission risk in COVID-19 patients with diabetes.