{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:02:25Z","timestamp":1777586545790,"version":"3.51.4"},"reference-count":77,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Endocrinol Diabetes"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Only 3 types of coronavirus cause aggressive respiratory disease in humans (MERS-Cov, SARS-Cov-1, and SARS-Cov-2). It has been reported higher infection rates and severe manifestations (ICU admission, need for mechanical ventilation, and death) in patients with comorbidities such as diabetes mellitus (DM). For this reason, this study aimed to determine the prevalence of diabetes comorbidity and its associated unfavorable health outcomes in patients with acute respiratory syndromes for coronavirus disease according to virus types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Systematic review of literature in Pubmed\/Medline, Scopus, Web of Science, Cochrane, and Scielo until April of 2020. We included cohort and cross-sectional studies with no restriction by language or geographical zone. The selection and extraction were undertaken by 2 reviewers, independently. The study quality was evaluated with Loney\u2019s instrument and data were synthesized by random effects model meta-analysis. The heterogeneity was quantified using an I\n                      <jats:sup>2<\/jats:sup>\n                      statistic. Funnel plot, Egger, and Begg tests were used to evaluate publication biases, and subgroups and sensitivity analyses were performed. Finally, we used the GRADE approach to assess the evidence certainty (PROSPERO: CRD42020178049).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We conducted the pooled analysis of 28 studies (n\u2009=\u20095960). The prevalence analysis according to virus type were 451.9 diabetes cases per 1000 infected patients (95% CI: 356.74-548.78; I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200989.71%) in MERS-Cov; 90.38\u2009per 1000 (95% CI: 67.17-118.38) in SARS-Cov-1; and 100.42\u2009per 1000 (95% CI: 77.85, 125.26 I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200967.94%) in SARS-Cov-2. The mortality rate were 36%, 6%, 10% and for MERS-Cov, SARS-Cov-1, and SARS-Cov-2, respectively. Due to the high risk of bias (75% of studies had very low quality), high heterogeneity ( I\n                      <jats:sup>2<\/jats:sup>\n                      higher than 60%), and publication bias (for MERS-Cov studies), we down rate the certainty to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The prevalence of DM in patients with acute respiratory syndrome due to coronaviruses is high, predominantly with MERS-Cov infection. The unfavorable health outcomes are frequent in this subset of patients. Well-powered and population-based studies are needed, including detailed DM clinical profile (such as glycemic control, DM complications, and treatment regimens), comorbidities, and SARS-Cov-2 evolution to reevaluate the worldwide prevalence of this comorbidity and to typify clinical phenotypes with differential risk within the subpopulation of DM patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1179551420962495","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:03:57Z","timestamp":1603152237000},"page":"117955142096249","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence of Diabetes Mellitus and Its Associated Unfavorable Outcomes in Patients With Acute Respiratory Syndromes Due to Coronaviruses Infection: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-5103","authenticated-orcid":false,"given":"Isabel","family":"Pinedo-Torres","sequence":"first","affiliation":[{"name":"Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magaly","family":"Flores-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinologia, Hospital Nacional Daniel Alcides Carri\u00f3n, Callao, Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlon","family":"Yovera-Aldana","sequence":"additional","affiliation":[{"name":"Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru"},{"name":"Red de Eficacia Cl\u00ednica y Sanitaria, REDECS, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7151-8793","authenticated-orcid":false,"given":"Claudia","family":"Gutierrez-Ortiz","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinologia, Hospital Nacional Daniel Alcides Carri\u00f3n, Callao, Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Zegarra-Lizana","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Intimayta-Escalante","sequence":"additional","affiliation":[{"name":"Sociedad Cientifica de San Fernando. Facultad de Medicina. Universidad Nacional Mayor de San Marcos, Lima, Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Moran-Mari\u00f1os","sequence":"additional","affiliation":[{"name":"Unidad de investigaci\u00f3n en bibliometr\u00eda, Universidad San Ignacio de Loyola, Lima, Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Alva-Diaz","sequence":"additional","affiliation":[{"name":"Universidad Cientifica del Sur, Facultad de Ciencias de la Salud, Lima, Peru"},{"name":"Red de Eficacia Cl\u00ednica y Sanitaria, REDECS, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Pacheco-Barrios","sequence":"additional","affiliation":[{"name":"Unidad de Investigaci\u00f3n para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"bibr1-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2020.1738501"},{"key":"bibr2-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-017-0101-8"},{"key":"bibr3-1179551420962495","first-page":"2781","volume":"24","author":"Ceccarelli M","year":"2020","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"bibr4-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-020-04628-0"},{"key":"bibr6-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.03.017"},{"key":"bibr7-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00646-x"},{"key":"bibr8-1179551420962495","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.2337\/dc20-0643","volume":"43","author":"Shitao R","year":"2020","journal-title":"Diabetes Care"},{"key":"bibr9-1179551420962495","doi-asserted-by":"publisher","DOI":"10.15252\/embj.20105114"},{"key":"bibr10-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.131774"},{"key":"bibr11-1179551420962495","author":"Chen X","year":"2020","journal-title":"medRxiv"},{"key":"bibr12-1179551420962495","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2019.02752"},{"key":"bibr13-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108142"},{"key":"bibr14-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1038\/nm1633"},{"key":"bibr15-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-009-0109-4"},{"key":"bibr16-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30116-8"},{"key":"bibr17-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcdt.2015.11.011"},{"key":"bibr18-1179551420962495","doi-asserted-by":"publisher","DOI":"10.3201\/eid2504.181595"},{"key":"bibr19-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3881-4"},{"key":"bibr20-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.5394"},{"key":"bibr21-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05180-x"},{"key":"bibr22-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"bibr23-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.10.011"},{"key":"bibr24-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"bibr25-1179551420962495","first-page":"170","volume":"19","author":"Loney PL","year":"1998","journal-title":"Chronic Dis Can"},{"key":"bibr26-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"bibr27-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"bibr28-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203104"},{"key":"bibr29-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X0800800403"},{"key":"bibr30-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1187"},{"key":"bibr32-1179551420962495","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"bibr33-1179551420962495","volume-title":"GRADE Handbook for Grading Quality of Evidence and Strength of Recommendation. 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