The Case Fatality Rate of Alpha Covid-19 Variant in Patients with Concurrent Diabetes or Chronic Kidney Disease: A Systematic Review and Meta-analysis

Critical Comments in Biomedicine Pub Date : 2022-06-19 DOI:10.18502/ccb.v3i1.9712

Farnia Ghanbarveisi, Zeinab Mohseni Afshar, Samira Shiri, Maliheh Dayani, K. Tavakol, M. Naderi, M. Rajati, M. Karami, Fatemeh Rajati

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Abstract

Background: People with diabetes or chronic kidney diseases (CKD) are vulnerable to Covid-19. Our aim in this study was to estimate the fatality rate among people with diabetes or CKD infected by Alpha Covid-19 variant. Methods: The authors searched PubMed, Scopus, and Embase from 1/12/2019 to 13/5/2020 to find studies that reported the fatality rate of Alpha Covid-19 variant among patients with diabetes/renal disease. A Random effects model meta-analysis was used to calculate the pooled case fatality rate (CFR). Then, a subgroup analysis was performed according to the sample size to find possible sources of heterogeneity. Results: In total, 22 papers were studied for diabetes and 10 papers for CKD. The pooled CFR was estimated at 23% (95% CI: 0.18, 0.28) among diabetes patients and 31% (95% CI: 0.16, 0.48) among renal patients. High heterogeneity was observed among the studies (Diabetes: I^2=94%, t^2=0.0173, P<0.01), (CKD: I^2=69%, t^2=0.0457, P<0.01). The subgroup analysis indicated that the sample size had a significant effect on fatality rate estimation. In the diabetes patients, the pooled CFR of Alpha Covid-19 variant was 40% (95% CI: 22%-58%; I^2=91%, t^2=0.0797, P<0.01) among the studies with the sample size of less than 52 hospitalized patients. In the studies with equal or more than 52 patients, the pooled CFR was 14% (95% CI: 11%-17%; I^2=88%, t^2=0.0048, P<0.01). In addition, in renal patients, the pooled CFR was 62% (95% CI: 0.06%-100%; I^2=85%, t^2=0.3745, P<0.01) in the studies with less than six hospitalized patients, and the pooled CFR was 23% (95% CI: 16%-31%; I^2=0%, t^2=0.00, P=0.58) among studies with more than 6 patients. Conclusions: People with either diabetes or CKD and infected with Alpha Covid-19 variant had a higher fatality rate in the general population. More care and vaccination is recommended for these patients. It is recommended that we calculate pooled estimation of the case fatality rate of the other variant of COVID-19 such as Beta, Delta, and Omicron in patients with chronic disease.

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合并糖尿病或慢性肾脏疾病患者α - Covid-19变异的病死率:一项系统综述和荟萃分析

背景:糖尿病或慢性肾脏疾病(CKD)患者易感染Covid-19。本研究的目的是估计α - Covid-19变异感染的糖尿病或CKD患者的死亡率。方法:作者检索了2019年12月1日至2020年5月13日期间PubMed、Scopus和Embase，以查找报告糖尿病/肾脏疾病患者α - Covid-19变异致死率的研究。随机效应模型荟萃分析用于计算合并病死率(CFR)。然后，根据样本量进行亚组分析，寻找可能的异质性来源。结果:共纳入糖尿病文献22篇，CKD文献10篇。糖尿病患者的总CFR估计为23% (95% CI: 0.18, 0.28)，肾病患者的总CFR估计为31% (95% CI: 0.16, 0.48)。各研究间存在高度异质性(糖尿病:I^2=94%， t^2=0.0173, P<0.01)， CKD: I^2=69%， t^2=0.0457, P<0.01)。亚组分析表明，样本量对病死率估计有显著影响。在糖尿病患者中，α - Covid-19变异的总CFR为40% (95% CI: 22%-58%;I^2=91%， t^2=0.0797, P<0.01)。在同等或多于52例患者的研究中，合并CFR为14% (95% CI: 11%-17%;I^2=88%， t^2=0.0048, P<0.01)。此外，在肾脏患者中，合并CFR为62% (95% CI: 0.06%-100%;I^2=85%， t^2=0.3745, P<0.01)，合并CFR为23% (95% CI: 16%-31%;I^2=0%， t^2=0.00, P=0.58)。结论:糖尿病或CKD患者感染α - covid变体的死亡率高于一般人群。建议对这些患者进行更多的护理和接种疫苗。建议我们对慢性疾病患者中其他COVID-19变体(如Beta、Delta和Omicron)的病死率进行汇总估计。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Critical Comments in Biomedicine

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