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Background and Aims: The novel coronavirus disease 2019 (COVID-19) has rapidly spread through the whole globe. Since the beginning of the outbreak, some individuals were more likely to manifest more severe outcomes. Diabetic patients were of that sort; however, the severity of COVID-19 in prediabetic ones remained less identified. This study aimed to systematically review and conduct a meta-analysis of the previously published observational studies investigating the severity of COVID-19 in prediabetic patients., Methods: Medline/PubMed, Scopus, EMBASE, Web of Science, Cochrane library, and google scholar databases were queried to identify relevant studies concerning prediabetes and serious COVID-19 outcomes. The Newcastle-Ottawa scale was used to assess the quality of the included studies. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the likelihood of severe presentations in prediabetic patients., Results: A total of 3027 patients were included in the meta-analysis. A random-effects model was used regarding the high heterogeneity (I 2  = 55%). Prediabetes was significantly associated with adverse outcomes of COVID-19 with an OR of 2.58 (95%CI, 1.46-4.56)., Conclusion: Prediabetes could act as a risk factor for the severity of COVID-19. Early detection of prediabetic patients might be helpful to adopt preventive and protective strategies to improve the prognosis of the infected individuals., Competing Interests: Declaration of competing interest The authors declare no relative competing interests., (Copyright © 2021. Published by Elsevier Ltd.)

Coronavirus disease 2019 (COVID-19) has been recently emerged with various manifestations, mainly on respiratory system. However, other organs might also be involved. Acute kidney injury has been reported as a complication with high variability and controversial results. We aimed to define the frequency of AKI as well as two specific renal biomarkers including BUN and serum Cr among individuals suffering from COVID-19 infection. We investigated Medline/PubMed, Scopus, and Google Scholar databases until 16th April 2020 and included all relevant peer-reviewed published studies without any language limitations. We further categorized patients according to their clinical status into severe, non-severe, and death groups. 18 records on 4528 individuals were assessed. The mean age of individuals were 52.5 ± 24.4 years (males: 55.6%). Prevalence of AKI was 4% (95% CI: 2% to 8%) and was significantly lower among non-severe patients in comparison to deceased ones (1%, 95% CI: 0% to 4%, vs. 31%, 95% CI: 19% to 47%). BUN mean was 5.14 mmol/L (95% CI: 4.60 to 5.69). Non-severe patients had remarkably lower means of BUN compared to deceased or those with severe infection (4.25 mmol/L, 95% Cl: 3.70 to 4.79, vs. 8.9 mmol/L, 95% CI: 7.94 to 9.86, vs. 6.63 mmol/L, 95% Cl: 5.62 to 7.65; respectively). The mean serum Cr was 71.60 mmol/L (95% Cl: 67.56 to 75.64). Our findings suggest that COVID-19 does not seem to involve renal system extensively and other possible mechanisms might be further investigated in this regard.

Background: Coronavirus disease 2019 (COVID-19) has been widespread since late December 2019, with several symptoms related to the upper and lower respiratory system. However, its cardiac manifestations are less frequently studied. We aimed to analyze the available COVID-19 data on acute cardiac injury, using troponin and brain natriuretic peptide (BNP) levels., Methods: We performed a systematic review on Medline/PubMed, Scopus, and Google Scholar databases until March 25, 2020. Relevant records reporting the incidence of acute cardiac injury as well as troponin and BNP levels were collected from published peer-reviewed articles with further analysis according to the clinical status of the patients (severe, non-severe, and death)., Results: Eleven records of 1394 individuals were included. The mean age of patients with acute cardiac injury was 56.6 ± 33.4 years (males: 54.3%). The incidence of acute cardiac injury was 15% (95% CI: 11, 20%). Further analysis revealed that dead or severe patients had significantly higher percentages of myocardial injury, compared to non-severe ones (peer-reviewed: 44%, 95% CI: 16, 74% vs. 24%, 95% CI: 15, 34% vs. 5%, 95% CI: 1, 12%, respectively). Mean total troponin was 10.23 pg/mL (95% CI: 5.98, 14.47), while 13% (95% CI: 8%, 18%) of patients had elevated levels. Mean BNP was 216.74 pg/mL (95% CI: 3.27, 430.20)., Conclusion: Acute cardiac injury in COVID-19 patients is more frequent than what was expected at the beginning of the outbreak. Meanwhile, further studies are needed to investigate the utility of cardiac biomarkers as diagnostic and prognostic tools for long-term cardiac complications of this infection., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)