Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 38097276 · doi:10.1136/bmjgh-2023-012581
What was done
Researchers conducted a systematic review and random-effects meta-analysis across 16 databases for original studies published between December 1, 2019, and December 31, 2020. Risk of bias was evaluated using an adapted Newcastle-Ottawa Scale, and publication bias was examined via contour-funnel plots and Egger's test. The authors pooled adjusted risk ratios to evaluate the associations of diabetes, hypertension, and obesity (BMI ≥30 kg/m²) with COVID-19 mortality.
What was found
From 34,830 identified records, 145 studies were included. Pooled adjusted risk ratios for COVID-19 mortality were 1.43 (95% CI 1.32 to 1.54) for diabetes, 1.19 (95% CI 1.09 to 1.30) for hypertension, and 1.39 (95% CI 1.27 to 1.52) for obesity. Risk ratios were stronger in studies conducted before April 2020, in the Western Pacific Region, in low- and middle-income countries, and in countries with lower Global Health Security Index scores.
Why it matters
These findings provide pooled, confounder-adjusted estimates demonstrating that diabetes, obesity, and hypertension independently increase COVID-19 mortality risk, particularly in resource-limited settings.
Limits
The literature search was restricted to the first year of the pandemic (2019-2020), before widespread vaccination and newer SARS-CoV-2 variants. Total participant count across the 145 studies, exact adjustment variables, and numerical estimates for subgroup analyses were not reported in the abstract.
Cited by
- supports Individuals with metabolic syndrome, type 2 diabetes, obesity, or hypertension have a significantly increased risk of severe COVID-19 outcomes.