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

AIM: The novel coronavirus infection (COVID-19), now a worldwide public health concern is associated with varied fatality. Patients with chronic underlying conditions like diabetes and hypertension have shown worst outcomes. The understanding of the association might be helpful in early vigilant monitoring and better management of COVID-19 patients at high risk. The aim of the meta-analysis was to assess the association of diabetes and hypertension with severity of disease. METHODS: A literature search was conducted using the databases PubMed and Cochrane until March 31, 2020. Seven studies were included in the meta- analysis, including 2018 COVID-19 patients. RESULTS: Diabetes was lower in the survivors (OR: 0.56; 95%CI: 0.35–0.90; p = 0.017; I(2): 0.0%) and non-severe (OR: 1.66; 95%CI: 1.20–2.30; p = 0.002; I(2): 0.0%) patients. No association of diabetes was found with ICU care. Hypertension was positively associated with death (OR: 0.49; 95%CI: 0.34–0.73; p<0.001; I(2): 0.0%), ICU care (OR: 0.42; 95%CI: 0.22–0.81; p = 0.009; I(2): 0.0%) and severity (OR: 2.69; 95%CI: 1.27–5.73; p = 0.01; I(2): 52.4%). CONCLUSIONS: Our findings suggest that diabetes and hypertension have a negative effect on health status of COVID-19 patients. However, large prevalence studies demonstrating the consequences of comorbid diabetes and hypertension are urgently needed to understand the magnitude of these vexatious comorbidities.