ReviewThe lancet. Diabetes & endocrinology2020
COVID-19 in people with diabetes: understanding the reasons for worse outcomes.
Review in The lancet. Diabetes & endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 4 registered trials, which are not on this map. Cited by 515 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
COVID-19, Aging, and Cardiometabolic Risk Factors (CARAMEL) Study: Integrating Aging, Cardiovascular, Metabolic, and Immunological Studies to Unravel COVID-19 Pathophysiology
Modulation of Gut Microbiota to Enhance Health and Immunity of Vulnerable Individuals During COVID-19 Pandemic
Prevalence and Impact of Diabetes Mellitus in Hospitalized COVID-19 Patients in a Tunisian Center: a Cross Sectional Study
Impaired Insulin Regulation Determining Severity of Severe Acute Respiratory Syndrome COVID-19 Infection Confounded by Ethnicity
Who cites it
515 citing papers in PubMed, 10 syntheses or guidelines pooled it, 937 citations in OpenAlex.
- Mortality Assessment in Patients with Cardiovascular Disease and COVID-19: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2026Pooled it
- Association of Chronic Hyperglycemia and Glycemic Variability with Mortality in COVID-19: Meta-Analysis of Cohort Studies.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Type 2 diabetes mellitus as a predictor of severe outcomes in COVID-19 - a systematic review and meta-analyses.BMC infectious diseases · 2025Pooled it
- Association of non-alcoholic fatty liver and metabolic-associated fatty liver with COVID-19 outcomes: A systematic review and meta-analysis.World journal of gastroenterology · 2023Pooled it
- Association Between Diabetes and Mortality Among Adult Patients Hospitalized With COVID-19: A Cohort Study of Hospitalized Adults in Ontario, Canada, and Copenhagen, Denmark.Canadian journal of diabetes · 2023Pooled it
- The bidirectional association between diabetes and long-COVID-19 - A systematic review.Diabetes research and clinical practice · 2023Pooled it
- Association between COVID-19 and sexual health: an umbrella review.Annals of medicine · 2023Pooled it
- Risk for newly diagnosed diabetes after COVID-19: a systematic review and meta-analysis.BMC medicine · 2022Pooled it
- The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19).Cardiovascular diabetology · 2022Pooled it
- In-hospital hyperglycemia but not diabetes mellitus alone is associated with increased in-hospital mortality in community-acquired pneumonia (CAP): a systematic review and meta-analysis of observational studies prior to COVID-19.BMJ open diabetes research & care · 2022Pooled it
- Trial
- Imaging findings of diabetic complications from head to toe: a comprehensive radiologic review.Japanese journal of radiology · 2026Review
- Observational
- Viral Respiratory Infections and Host Immune Dynamics in Diabetes: Clinical Outcomes in the Post-COVID Era.Microorganisms · 2026Article
- Short-Term Outcomes in Neonates Born to Diabetic Mothers During the Coronavirus Disease 2019 Pandemic: A Descriptive Study.AJP reports · 2026Article
- Burden and Outcomes of Viral Respiratory Infections Among Adults in Bahrain: A Retrospective Cohort Study.Cureus · 2026Article
- Long term cardiometabolic outcomes in COVID positive patients.Journal of public health research · 2026Review
- Comparison of Severe COVID-19 Outcomes in Vaccinated and Unvaccinated Patients, with and Without Diabetes Mellitus in a Romanian Tertiary Healthcare Pneumology Hospital-A Retrospective Study.International journal of molecular sciences · 2026Article
- Diabetes Mellitus and In-Hospital Outcomes in Hospitalized COVID-19 Patients: A Single-Center Eastern European Cohort Study (2020-2024).Medicina (Kaunas, Lithuania) · 2026Observational
- Mortality trends related to cardiac arrest in patients with diabetes mellitus aged 25 and older across the United States: an analysis using the CDC WONDER database from 1999 to 2024.Archives of medical science : AMS · 2026Article
455 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
- Erratum issued
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since the initial COVID-19 outbreak in China, much attention has focused on people with diabetes because of poor prognosis in those with the infection. Initial reports were mainly on people with type 2 diabetes, although recent surveys have shown that individuals with type 1 diabetes are also at risk of severe COVID-19. The reason for worse prognosis in people with diabetes is likely to be multifactorial, thus reflecting the syndromic nature of diabetes. Age, sex, ethnicity, comorbidities such as hypertension and cardiovascular disease, obesity, and a pro-inflammatory and pro-coagulative state all probably contribute to the risk of worse outcomes. Glucose-lowering agents and anti-viral treatments can modulate the risk, but limitations to their use and potential interactions with COVID-19 treatments should be carefully assessed. Finally, severe acute respiratory syndrome coronavirus 2 infection itself might represent a worsening factor for people with diabetes, as it can precipitate acute metabolic complications through direct negative effects on β-cell function. These effects on β-cell function might also cause diabetic ketoacidosis in individuals with diabetes, hyperglycaemia at hospital admission in individuals with unknown history of diabetes, and potentially new-onset diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.