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Review
. 2021 Feb 26;20(1):905-917.
doi: 10.1007/s40200-021-00768-5. eCollection 2021 Jun.

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Hamid Mirjalili  1 , Seyed Alireza Dastgheib  2 , Seyed Hossein Shaker  3 , Reza Bahrami  4 , Mahta Mazaheri  5   6 , Seyed Mohamad Hossein Sadr-Bafghi  7 , Jalal Sadeghizadeh-Yazdi  8 , Hossein Neamatzadeh  5   6
Affiliations
Review

Proportion and mortality of Iranian diabetes mellitus, chronic kidney disease, hypertension and cardiovascular disease patients with COVID-19: a meta-analysis

Hamid Mirjalili et al. J Diabetes Metab Disord. .

Abstract

Background: Currently, the number of patients with SARS-COV-2 infection has increased rapidly in Iran, but the risk and mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (DM), chronic kidney disease (CKD), hypertension and cardiovascular diseases (CVDs) still not clear. The aim of this meta-analysis was to estimate the proportion and mortality of SARS-COV-2 in these patients.

Methods: A comprehensive literature search was carried out in PubMed, Web of Sciences, Cochrane Library, EMBASE, CNKI, SciELO, and other databases to identify all relevant studies published up to 10 January, 2020. The proportion and mortality in the patients were assessed by odd ratio (OR) and the corresponding 95 % confidence interval (95 % CI).

Results: A total of ten case-series including 11,755 cases with SARS-COV-2 infection and 942 deaths were selected. Among them, there were total of 791 DM patients with 186 deaths, 225 CKD patients with 45 deaths, 790 hypertension cases with 86 deaths, and 471 CVDs cases with 60 deaths. Pooled data revealed that the proportion of SARS-COV-2 infection in the patients with hypertension, DM, CVDs and CKD were 21.1 %, 16.3 %, 14.0 % and 5.0 %, respectively. Moreover, the SARS-COV-2 infection were associated with an increased risk of mortality in DM (OR = 0.549, CI 95 % 0.448-0.671, p ≤ 0.001) and CKD (OR = 0.552, 95 % CI 0.367-0.829, p = 0.004) patients, but not hypertension and CVDs. There was no publication bias.

Conclusions: Our pooled data showed that the proportion of SARS-COV-2 infection was the highest in the Iranian patients with hypertension (21.1 %) followed by DM (16.3 %), CVDs (14.0 %) and CKD (5.0 %). Moreover, DM and CKD in patients with SARS-COV-2 infection were associated with a 0.549 and 0.552-fold increase in mortality, respectively. Clinicians in Iran should be aware of these findings, to identifying patients at higher risk and inform interventions to reduce the risk of death. Moreover, well-designed, large-scale and multicenter studies are needed to improve and validate our findings.

Keywords: COVID-19; Cardiovascular disease; Chronic kidney disease; Diabetes; Hypertension; SARS-COV-2.

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Conflict of interest statement

Conflicts of interest/Competing interestsThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The study selection and inclusion process
Fig. 2
Fig. 2
Forest plots for proportion (a) and mortality (b) in the Iranian diabetes mellitus patients with SARS-COV-2 Infection
Fig. 3
Fig. 3
Forest plots for proportion (a) and mortality (b) in the Iranian chronic kidney disease patients with SARS-COV-2 Infection
Fig. 4
Fig. 4
Forest plots for proportion (a) and mortality (b) in the Iranian hypertension patients with SARS-COV-2 Infection
Fig. 5
Fig. 5
Forest plots for proportion (a) and mortality (b) in the Iranian cardiovascular disease patients with SARS-COV-2 Infection
Fig. 6
Fig. 6
Begg’s funnel plot for publication bias test for proportion of SARS-COV-2 infection in Iranian patients with diabetes mellitus (a), chronic kidney disease (b), hypertension (c) and cardiovascular disease (d)
Fig. 7
Fig. 7
Begg’s funnel plot for publication bias test for mortality of SARS-COV-2 infection in Iranian patients with diabetes mellitus (a), chronic kidney disease (b), hypertension (c) and cardiovascular disease (d)
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