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. 2020 Aug 31:12:75.
doi: 10.1186/s13098-020-00586-4. eCollection 2020.

Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: a meta-analysis

Bianca de Almeida-Pititto  1   2   3 , Patrícia M Dualib  2   3   4 , Lenita Zajdenverg  2   5 , Joana Rodrigues Dantas  5 , Filipe Dias de Souza  3 , Melanie Rodacki  2   5 , Marcello Casaccia Bertoluci  2   6   7 ; Brazilian Diabetes Society Study Group (SBD)
Affiliations

Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: a meta-analysis

Bianca de Almeida-Pititto et al. Diabetol Metab Syndr. .

Abstract

Background: The aim of this study is to evaluate the impact of diabetes, hypertension, cardiovascular disease and the use of angiotensin converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB) with severity (invasive mechanical ventilation or intensive care unit admission or O2 saturation < 90%) and mortality of COVID-19 cases.

Methods: Systematic review of the PubMed, Cochrane Library and SciELO databases was performed to identify relevant articles published from December 2019 to 6th May 2020. Forty articles were included involving 18.012 COVID-19 patients.

Results: The random-effect meta-analysis showed that diabetes mellitus and hypertension were moderately associated respectively with severity and mortality for COVID-19: Diabetes [OR 2.35 95% CI 1.80-3.06 and OR 2.50 95% CI 1.74-3.59] Hypertension: [OR 2.98 95% CI 2.37-3.75 and OR 2.88 (2.22-3.74)]. Cardiovascular disease was strongly associated with both severity and mortality, respectively [OR 4.02 (2.76-5.86) and OR 6.34 (3.71-10.84)]. On the contrary, the use of ACEI/ARB, was not associate with severity of COVID-19.

Conclusion: In conclusion, diabetes, hypertension and especially cardiovascular disease, are important risk factors for severity and mortality in COVID-19 infected people and are targets that must be intensively addressed in the management of this infection.

Keywords: COVID-19; Cardiovascular disease; Diabetes; Hypertension; Mortality; SARS-CoV-2; Severity.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart (PRISMA) showing the meta-analysis studies selection
Fig. 2
Fig. 2
Meta-analysis with forest plot presenting the OR and 95% CI for severity or mortality of COVID-19 according to the presence of diabetes mellitus, hypertension, cardiovascular disease or ACEI/ARB exposure. a Diabetes and COVID-19 severity, b Diabetes and COVID-19 mortality, c Hypertension and COVID-19 severity, d Hypertension and COVID-19 mortality, e Cardiovascular disease and COVID-19 severity, f Cardiovascular disease and COVID-19 mortality, g ACEI/ARBs exposure and COVID-19 severity
Fig. 2
Fig. 2
Meta-analysis with forest plot presenting the OR and 95% CI for severity or mortality of COVID-19 according to the presence of diabetes mellitus, hypertension, cardiovascular disease or ACEI/ARB exposure. a Diabetes and COVID-19 severity, b Diabetes and COVID-19 mortality, c Hypertension and COVID-19 severity, d Hypertension and COVID-19 mortality, e Cardiovascular disease and COVID-19 severity, f Cardiovascular disease and COVID-19 mortality, g ACEI/ARBs exposure and COVID-19 severity
Fig. 2
Fig. 2
Meta-analysis with forest plot presenting the OR and 95% CI for severity or mortality of COVID-19 according to the presence of diabetes mellitus, hypertension, cardiovascular disease or ACEI/ARB exposure. a Diabetes and COVID-19 severity, b Diabetes and COVID-19 mortality, c Hypertension and COVID-19 severity, d Hypertension and COVID-19 mortality, e Cardiovascular disease and COVID-19 severity, f Cardiovascular disease and COVID-19 mortality, g ACEI/ARBs exposure and COVID-19 severity
See this image and copyright information in PMC

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