JMIR Publications

ABSTRACT

Background:

Coronavirus disease 2019 (COVID-19), an infectious disease pandemic, affected millions of people globally, resulting in high morbidity and mortality. Causing further concern, significant proportions of COVID-19 survivors suffer from the lingering health effects of severe acute respiratory syndrome virus 2 (SARS-CoV-2), the pathogen that causes COVID-19. One of the diseases manifesting as a post-acute sequela of COVID-19 is new-onset diabetes.

Objective:

This systematic review and meta-analysis will perform a comprehensive literature search to estimate the burden of new-onset diabetes after COVID-19. Specifically, this study will estimate the magnitude of the incidence, risk, and population-attributable fraction of new-onset diabetes in long-COVID patients. The study will also explore and summarize the data on the clinical course of the new-onset diabetes cases.

Methods:

The study will be conducted in accordance with the Cochrane Handbook for Systematic Reviews and the findings will be reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A comprehensive search strategy for each bibliographic database will be developed using a mix of subject headings and text words. Five databases, including PubMed, MEDLINE, Embase, Scopus, and Web of Science, will be searched for eligible studies. The World Health Organization COVID-19 Research Database, preprint servers, and conference abstracts will also be searched. Cohort studies of COVID-19 patients of all ages providing data on new cases of diabetes in the long-COVID phase of the illness will be included. Two independent reviewers will perform article selection, data extraction, and quality assessment of the studies. The random-effects DerSimonian-Laird models will be used to conduct meta-analysis. Publication bias will be assessed by funnel plots and Egger’s test. Based on the data availability, sub-group analyses by age, sex, follow-up time, the pandemic phase, time since the diagnosis of diabetes, type of diabetes, comorbidities, glycemic status (normal glucose tolerance or prediabetes), controls (general population or with respiratory tract infections), race or ethnicity, and country are planned. A two-sided p<0.05 will be considered statistically significant for analyses.

Results:

The initial search of this systematic review began in August 2023, with the conclusive search anticipated to conclude by November 2023. Currently, data extraction is underway, and the process is expected to be finalized by December 2023.

Conclusions:

The study findings will potentially inform clinical practice and public health guidelines for early detection and treatment of new-onset diabetes in long-COVID patients. Clinical Trial: PROSPERO (No.CRD42020200432).