Evaluation of Cardiovascular Diseases and Diabetes Mellitus as Predisposing Factors for Mortality in Patients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis

BACKGROUND: Coronavirus disease 2019 (COVID-19) has long-lasting effects on health, social well-being, and national economies worldwide because of its high infection and mortality rates. The risk is especially high in patients with cardiovascular diseases (CVD) and diabetes mellitus (DM). Objective: To analyse the association of CVD and DM with mortality in patients infected with COVID-19. METHODS: A systematic review of the Medline, PubMed, Embase, SciELO and Cochrane Collaboration Library was performed to determine pertinent studies conducted and published from December 2019 to October 2020. Study selection, data extraction and quality assessment, data synthesis and analysis, and determination of risk of bias were conducted by 2 pairs of reviewers in a double-blinded manner. The risk of bias and heterogeneity between studies was evaluated using the Cochrane system and Q-test. A random-effects model was used to evaluate results with Revman 5.3 software. RESULTS: A total of 11 studies with total of 5032 patients (including 286 with CVD and 532 with DM) were recruited and analysed. Meta-analysis revealed that DM was moderately related to mortality of COVID-19: [odds-ratio (OR) 2.50, 95% confidence interval (CI) 1.70-3.60; p=0.032] and CVD was significantly related to mortality for COVID-19 (OR 6.30, 95% CI 3.70-10.80, p=0.074). Conclusion: In conclusion, DM and particularly CVD are significant predisposing factors for mortality in patients with COVID-19. Meticulous evaluation of these patients must be performed for better management.