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Prevalence of Diabetes and Hypertension and Their Associated Risks for Poor Outcomes in Covid-19 Patients

  • Barrera, Francisco J ORCID Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota
  • Shekhar, Skand ORCID Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
  • Wurth, Rachel ORCID Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
  • Moreno-Pena, Pablo J Plataforma INVEST-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
  • Ponce, Oscar J Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
  • Hajdenberg, Michelle College of Arts and Sciences at Washington University in St. Louis, Saint Louis, Missouri
  • Alvarez-Villalobos, Neri A Research Unit, School of Medicine and University Hospital “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
  • Hall, Janet E Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Research Triangle Park, North Carolina
  • Schiffrin, Ernesto L ORCID Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Montreal, Quebec, Canada
  • Eisenhofer, Graeme ORCID Institute of Clinical Chemistry and Laboratory Medicine, and Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • Porter, Forbes Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland
  • Brito, Juan P Knowledge and Evaluation Research, Mayo Clinic, Rochester, Minnesota
  • Bornstein, Stefan R ORCID Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, University Hospital of Zürich, Zürich, Switzerland
  • Stratakis, Constantine A ORCID Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
  • González-González, José Gerardo Research Unit, School of Medicine and University Hospital “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
  • Rodíguez-Gutiérrez, René Research Unit, School of Medicine and University Hospital “Dr. Jose E. Gonzalez”, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo León, Mexico
  • Hannah-Shmouni, Fady ORCID Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland
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  • 2020-7-21
Published in:
  • Journal of the Endocrine Society. - The Endocrine Society. - 2020, vol. 4, no. 9
English Abstract


Coronavirus disease 2019 (Covid-19) has affected millions of people and may disproportionately affect those with hypertension and diabetes. Because of inadequate methods in published systematic reviews, the prevalence of diabetes and hypertension and associated risks of poor outcomes in Covid-19 patients are unknown. We searched databases from December 1, 2019, to April 6, 2020, and selected observational peer-reviewed studies in English of patients with Covid-19. Independent reviewers extracted data on study participants, interventions, and outcomes and assessed risk of bias, and the certainty of evidence. We included 65 (15 794 participants) observational studies at moderate to high risk of bias. Overall prevalence of diabetes and hypertension was 12% (95% confidence interval [CI], 10-15; n = 12 870; I2: 89%), and 17% (95% CI, 13-22; n = 12 709; I2: 95%), respectively. In severe Covid-19, the prevalence of diabetes and hypertension were 18% (95% CI, 16-20; n = 1099; I2: 0%) and 32% (95% CI, 16-54; n = 1078; I2: 63%), respectively. Unadjusted relative risk for intensive care unit admission and mortality were 1.96 (95% CI, 1.19-3.22; n = 8890; I2: 80%; P = .008) and 2.78 (95% CI, 1.39-5.58; n = 2058; I2: 75%; P = .0004) for diabetics; and 2.95 (95% CI, 2.18-3.99; n = 1737; I2: 0%; P < .001) and 2.39 (95% CI, 1.54-3.73; n = 3107; I2: 66%; P < .001) for hypertensives. Neither diabetes (1.50; 95% CI, 0.90-2.50; n = 1991; I2: 74%; P = .119) nor hypertension (1.48; 95% CI, 0.99-2.23; n = 2023; I2: 69%; P = .058) was associated with severe Covid-19. In conclusion, the risk of intensive care unit admission and mortality for patients with diabetes or hypertension who developed Covid-19 is increased compared with those without these comorbidities.


PROSPERO registration number
CRD42020176582.
Language
  • English
Open access status
gold
Identifiers
Persistent URL
https://sonar.ch/global/documents/18592
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