Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis

Parveen, Rizwana; Sehar, Nouroz; Bajpai, Ram; Agarwal, Nidhi

doi:10.1016/j.diabres.2020.108295

Cited by 69 publications

(89 citation statements)

References 17 publications

(32 reference statements)

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“…The current rapid review and meta-analysis pools the within-study adjusted measure of association and therefore strengthens the evidence emerging from the pandemic, revealing the association between diabetes and severe clinical outcomes if people with pre-existing diabetes become hospitalized due to infection with COVID-19. In agreement with emerging evidence [6,10,[64][65][66][67], we report that people hospitalized for COVID-19 with pre-existing diabetes have a 1.6 times increased risk or 2-fold increased odds of experiencing the composite outcome (mortality, admittance to ICU, requirement for IMV, clinically defined severe or critical disease). This finding strengthens the evidence of diabetes as a risk factor in patients hospitalized due to COVID-19 and their increased likelihood of developing a severe clinical course.…”

Section: Discussionsupporting

confidence: 90%

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

Kubjane

McCreedy²,

Cariou

et al. 2020

J Endocrinol Metab

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Background: Addressing the urgent need for evidence on diabetes as a serious comorbidity for severe illness and death from coronavirus disease 2019 (COVID-19), we investigated the association between diabetes and COVID-19 disease severity in patients hospitalized due to COVID-19. Methods: This rapid review and meta-analysis was undertaken in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE and EMBASE were searched for studies published between January 1 and May 20, 2020. Studies included were English language, peer-reviewed, observational studies of adults hospitalized for COVID-19 with reported clinical course and living with or without diabetes. The severity of clinical course was assessed using a composite outcome (mortality, admittance to intensive care unit (ICU), requirement for invasive mechanical ventilation (IMV), clinically defined severe or critical disease). Data and adjusted measures of association were extracted from published reports, and meta-analysis was performed using a random effects model. The protocol was registered with OSF (https://osf.io/agsyb/). Results: A literature search yielded 431 articles, of which 45 studies (22,091 patients) met the inclusion criteria and 14 studies (12,383 patients) reported an adjusted measure of association for diabetes with the composite outcome with pooled hazard ratio 1.59 (95% confidence interval 1.3-1.93; I 2 = 0%, P = 0.820) and pooled odds ratio of 2.15 (95% confidence interval 1.63-2.83; I 2 = 0%, P = 0.892); evidence by GRADE was moderate. Conclusions: People living with diabetes are more likely to develop severe COVID-19 clinical course if hospitalized for COVID-19 than people not living with diabetes. To inform clinical decision-making during the pandemic, our findings support that people living with diabetes who are hospitalized for COVID-19 should be prioritized when triaged as at increased risk for the development of severe clinical course.

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Section: Discussionsupporting

confidence: 90%

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

Kubjane

McCreedy²,

Cariou

et al. 2020

J Endocrinol Metab

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“…In this study, COVID-19 was associated with increased age and heart diseases (atrial brillation). These data are in line with the current knowledge of SARS-Cov2 infection [23,24]. The lower prevalence of ACE inhibitor intake among COVID-19 seropositive patients does not support the hypothesis that these molecules could make patients more susceptible to SARS-Cov2 infection.…”

Section: Discussionsupporting

confidence: 46%

Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

Strazzulla

Tarteret

Postorino

et al. 2020

Preprint

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Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome 2 (SARS-Cov2) infection, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity, 78% of specificity, 79% of positive predictive value and 64% of negative predictive value.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia, 15/32 (46.8%) fever, 8/32 (25%) fatigue, 8/32 (25%) cough, 6/32 (18.8%) diarrhoea, 4/32 (12.5%) severe respiratory distress requiring oxygen therapy, 4/32 (12.5%) fall, 3/32 (9.4%) conjunctivitis, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence of atrial fibrillation (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic residents. Seropositive residents had lower prevalence of diabetes (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths among nursing home residents, even in absence of molecular diagnosis.

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“…The knowledge, attitude, and prevention practice toward COVID-19 is an important issue because studies reported as they have to have health impact on COVID-19. [14][15][16] We had intentionally excluded children and adolescents less than 18 years and patients with a severe and uncorrectable cognitive, visual, or hearing impairment were excluded from the study as we wanted to assess the KAP of the patients and not their parents. The present study found about 68.66% of the study participants have moderate and good knowledge.…”

Section: Discussionmentioning

confidence: 99%

<p>COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia</p>

Taye¹,

Bose²,

Beressa³

et al. 2020

IDR

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Background: To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town. Patients and Methods: Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used. Results: The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge. Conclusion: The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.

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Association of diabetes and hypertension with disease severity in covid-19 patients: A systematic literature review and exploratory meta-analysis

Cited by 69 publications

References 17 publications

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

Association of Diabetes and Severe COVID-19 Outcomes: A Rapid Review and Meta-Analysis

Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

<p>COVID-19 Knowledge, Attitudes, and Prevention Practices Among People with Hypertension and Diabetes Mellitus Attending Public Health Facilities in Ambo, Ethiopia</p>

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