Ek Hastalıklar ile COVID-19 Kaynaklı Mortalite Arasındaki İlişki: Meta Analiz Çalışması

Abstract

Amaç: Bu çalışmada, hayatta kalan ve ölen hastalardaki ek hastalık oranları incelenerek ek hastalık varlığı ile COVID-19 kaynaklı mortalite arasındaki ilişkinin ortaya konması amaçlandı. Yöntem: Bu meta-analiz çalışması için Scopus, PubMed ve Web of Science veri tabanları üzerinde, Ocak 2021'e kadar makale taraması yapıldı. Hastalara ilişkin sonuç değişkeni olarak ölüm seçildi. Ek hastalıklar; böbrek hastalığı, hipertansiyon, diyabet, kardiyovasküler hastalık, karaciğer hastalığı, otoimmün hastalık ve malignite olarak seçildi. Odds oranlarını (OR) belirlemek için sabit etkili ve rastgele etkili meta-analiz kullanıldı. Heterojenlik varlığı Ki-kare ve Higgins I2 testleri ile değerlendirildi. Yayın yanlılığı ise huni grafiği ve Hegger testi ile incelendi. Bulgular: Bu meta-analizde 16 çalışmadan elde edilen 11467 COVID-19 hastasına ilişkin sonuçlar kullanıldı. Böbrek hastalığı varlığı (OR=2,30; %95 GA: 1,96-2,70; p<0,001), hipertansiyon varlığı (OR=2,14; %95 GA: 1,67-2,76; p<0,001), diyabet varlığı (OR=1,85; %95 GA: 1,63-2,10; p<0,001), kardiyovasküler hastalık varlığı (OR=2,85; %95 GA: 2,00-4,06; p<0,001) ölen hastalarda daha yüksekti. Karaciğer hastalığı, malignite ve otoimmün hastalık bakımından ise anlamlı bir fark bulunamadı (p>0,05). Sonuç: Bu meta-analiz çalışması; böbrek hastalığı, hipertansiyon, diyabet ve kardiyovasküler hastalık gibi majör ek hastalıkların COVID-19 kaynaklı ölüm riskini artırdığını göstermektedir. Bu nedenle çalışmamızda, spesifik ek hastalığı olan hastaların ihtiyaçlarını karşılamak için uygun tedavi seçiminin ne kadar önemli olduğu vurgulanmaktadır.

Keywords

• COVID-19
• mortalite
• meta-analiz
• ek hastalıklar

Association between Pre-Existing Comorbidities and COVID-19 Related Mortality: A Meta-Analysis Study

Abstract

Objective: In our study, we aimed to examine the proportion of comorbidities in survivors and non-survivors and investigate the association between the comorbidities and COVID-19 related mortality. Methods: We searched Scopus, PubMed and Web of Science for articles up to January, 2021. Patients’ outcomes were selected as survived and non-survived. Comorbidities were selected as kidney disease, hypertension, diabetes mellitus, cardiovascular disease, liver disease, autoimmune disease and malignancy. Odds ratios (ORs) were reported using fixed-effect and random-effect meta-analysis. The heterogeneity was assessed by the Chi-square test and Higgins' I2 test. The publication bias was examined via funnel plot and Hegger’s test. Results Our meta-analysis was conducted based on 11467 COVID-19 cases from 16 studies. Compared to the survivors, the odds of kidney disease (OR=2.30; 95% CI: 1.96-2.70; p<0.001), odds of hypertension (OR=2.14; 95% CI: 1.67-2.76; p<0.001), odds of diabetes mellitus (OR=1.85; 95% CI: 1.63-2.10; p<0.001), odds of cardiovascular disease (OR=2.85; 95% CI: 2.00-4.06; p<0.001) were higher in non-survivors. There was no significant difference for the odds of liver disease, malignancy and autoimmune disease (p>0.05). Conclusion: Our meta-analysis suggests that the major comorbidities such kidney disease, hypertension, diabetes mellitus and cardiovascular disease increase the risk of death from COVID-19 disease. Our study also highlights the importance of appropriate treatment for the patients with these specific comorbidities to meet their need.

Keywords

• Comorbidities
• COVID-19
• mortality
• meta-analysis

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