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

Hamid Mirjalili; Seyed Alireza Dastgheib; Seyed Hossein Shaker; Reza Bahrami; Mahta Mazaheri; Seyed Mohamad Hossein Sadr-Bafghi; Jalal Sadeghizadeh-Yazdi; Hossein Neamatzadeh

doi:10.1007/s40200-021-00768-5

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

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

Authors

Hamid Mirjalili¹, Seyed Alireza Dastgheib², Seyed Hossein Shaker³, Reza Bahrami⁴, Mahta Mazaheri^{5

6}, Seyed Mohamad Hossein Sadr-Bafghi⁷, Jalal Sadeghizadeh-Yazdi⁸, Hossein Neamatzadeh^{5

6}

Affiliations

¹ Department of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
² Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran.
⁴ Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁵ Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁶ Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁷ Department of Cardiology, Islamic Azad University, Yazd Branch, Yazd, Iran.
⁸ Department of Food Science and Technology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

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.

Publication types

Review